Organization
PHARMACY HEALTH SERVICES INC
Active
Other names
Wilcox Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE GRAY (COO)
(802) 388-1575
Entity
Organization
Contact information
Practice address
252 STRATTON RD, RUTLAND, VT 05701-4623
(802) 775-3351
(802) 774-5052
Mailing address
PO BOX 69, MIDDLEBURY, VT 05753-0069
(802) 775-3351
(802) 774-5052
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
038.0125476
VT
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162591
PK
—
Enumeration date
11/09/2016
Last updated
01/20/2017
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