Organization
SHIRE APOTHECARY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IMANTS VITOLS (PRES.)
(802) 457-2707
Entity
Organization
Contact information
Practice address
13 ELM STREET, WOODSTOCK, VT 05091
(802) 457-2707
(802) 457-3008
Mailing address
13 ELM STREET, WOODSTOCK, VT 05091
(802) 457-2707
(802) 457-3008
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0350001163
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007164
—
VT
Enumeration date
05/03/2007
Last updated
08/22/2020
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