Granite Pharmacy Inc

LBN: Granite Pharmacy Inc.
Granite Pharmacy Inc is an health care organization with primary practice located at 576 Ballard Rd Ste 2 , Milton VT 05468-4210. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Granite Pharmacy Inc. can be contacted via phone (802) 527-9930, or through Dockham, Lisa via phone (802) 527-9930.

Contact Information

Primary practice address
576 Ballard Rd Ste 2 Milton VT 05468-4210
Phone: (802) 527-9930
Fax: (802) 527-9764
Website:
Map and Directions
Authorized official contact:
Name: Dockham, Lisa RPH.
Phone: (802) 527-9930

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Long Term Care Pharmacy 3336L0003X 141-0003297 Vermont

Profile Details

NPI number 1205878501
LBN Legal business name Granite Pharmacy Inc.
DBA Doing business as Granite Pharmacy Inc
Authorized official Dockham, Lisa RPH.
Entity Organization
Organization subpart 1 No
Enumeration date Jun 12th, 2006
Last updated Oct 26th, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205878501 NPPES
Other 2101633 PK
MEDICAID 1006503 PK

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