Provider Demographics
NPI:1497753826
Name:BARTON PHARMACY INCORPORATED
Entity type:Organization
Organization Name:BARTON PHARMACY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:802-525-4098
Mailing Address - Street 1:16 CHURCH ST
Mailing Address - Street 2:PO BOX 578
Mailing Address - City:BARTON
Mailing Address - State:VT
Mailing Address - Zip Code:05822-8511
Mailing Address - Country:US
Mailing Address - Phone:802-525-4098
Mailing Address - Fax:802-525-3794
Practice Address - Street 1:16 CHURCH ST
Practice Address - Street 2:
Practice Address - City:BARTON
Practice Address - State:VT
Practice Address - Zip Code:05822-8511
Practice Address - Country:US
Practice Address - Phone:802-525-4098
Practice Address - Fax:802-525-3794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-10
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT038-0003327183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1008109Medicaid
VT1008109Medicaid