Individual
MARY J GAGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
115 SEYMOUR DRIVE, WAL-MART PHARMACY, DERBY, VT 05829
(802) 624-8011
Mailing address
115 SEYMOUR DRIVE, WAL-MART PHARMACY, NEWPORT, VT 05855
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
033.0104313
VT
Other
Enumeration date
07/28/2014
Last updated
10/19/2016
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