NIKLAS-MOORE INC (NPI# 1184646192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184646192 |
| Entity Type | Organization |
| Organization Name | NIKLAS-MOORE INC |
| Other Organization Name | GREEN MOUNTAIN PHARMACY |
| Practice Address |
5700 Rt 100 Unit C-10 Londonderry VT 05148-0576 |
| Mailing Address |
5700 Rt 100 Unit C-10 Po Box 576 Londonderry VT 05148-0576 |
| Practice Telephone | 8028243344 |
| Practice Fax Number | 8028243332 |
| Mailing Telephone | 8028243344 |
| Mailing Fax Number | 8028243332 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SARA KAY NIKLAS (OWNER MANAGER) |
| Authorized Official Telephone | 8028243344 |
| Authorized Official Credential | PHARMD RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 0380003348 | VT | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 1011164 | 05 |
| Other Name | Type Code |
|---|---|
| Green Mountain Pharmacy | Doing Business As Name - Organization |
| Street Address |
5700 RT 100 UNIT C-10 |
| City | LONDONDERRY |
| State | VT |
| Zip Code | 05148-0576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952374001 | Roger C Fox | Internal Medicine | 38 Rt 11, Londonderry, VT 05148 | 2006-02-09 |
| 1609970078 | Cynthia Harris | Nurse Practitioner | 38 Rt 11, Mountain Valley Health Center, Londonderry, VT 05148 | 2006-09-07 |
| 1659393064 | Ronald Vallario | Family Medicine | 38 Rt 11, Londonderry, VT 05148 | 2006-07-24 |
| 1578536629 | Mountain Valley Health Council Inc. | Family Medicine | 38 Rt 11, Londonderry, VT 05148 | 2006-02-09 |
| 1982897203 | Mountain Valley Health Council Inc | Clinic/Center | 38 Rte 11, Londonderry, VT 05148-0310 | 2007-08-21 |
| 1699903260 | Green Mountain Community Medical and Social Services | Social Worker | 5700 Vt Route 100, Mountain Marketplace, Ste. A6, Londonderry, VT 05148-9400 | 2009-06-23 |
| 1588154439 | Dianna Beevers Scott | Speech-Language Pathologist | 91 Vt Route 11, Londonderry, VT 05148-9539 | 2018-05-16 |
| 1932565611 | Springfield Hospital Inc | Clinic/Center | 38 Vt Route 11, Londonderry, VT 05148-9555 | 2016-01-11 |
| 1639544331 | Springfield Medical Care Systems Inc | Clinic/Center | 38 Vermont Route 11, Londonderry, VT 05148-9555 | 2015-12-07 |
| 1326187204 | Melanie Mary Canon | Family Medicine | 38 Route 11, Londonderry, VT 05148-9555 | 2007-02-06 |
| Find all providers in zip 05148 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710452412 | Mackenzie Moore | Pharmacist | 7 Raven Ter, Londonderry, NH 03053-3926 | 2018-10-09 |
| 1568747970 | Rachel Marie Wetson | Pharmacist | 119 Rockingham Rd, Londonderry, NH 03053 | 2011-10-17 |
| 1942514641 | Ryan Michael Tannian | Pharmacist | 13 Commerce Ave, Londonderry, NH 03053-4402 | 2010-08-05 |
| 1851513832 | Susan Catherine Carty | Pharmacist | 123 Nashua Rd, Londonderry, NH 03053-3453 | 2007-05-02 |
| 1851511810 | Constantina Plentzas | Pharmacist | 34 Nashua Rd, Londonderry, NH 03053-3406 | 2007-05-01 |
| 1851516421 | Eleazer Carver V | Pharmacist | 97 Mammoth Rd, Londonderry, NH 03053-3819 | 2007-04-17 |
| 1114036993 | Anthony Joseph Gallo | Pharmacist | Rt 102, Old Orchard View Dr, Londonderry, NH 03053-3214 | 2006-08-29 |
| 1265421242 | Richard A Cohen | Pharmacist | 17 Lori Ln, Londonderry, NH 03053-2378 | 2005-10-21 |
| 1851387237 | Steve Harry Willnus | Pharmacist | 23 S Perimeter Rd, Londonderry, NH 03053-2041 | 2005-09-21 |
| 1104427244 | Erica L Lussier | Pharmacist | 6 Hampton Dr, Londonderry, NH 03053-3424 | 2020-11-05 |
| Find all providers in LONDONDERRY | ||||
| City | LONDONDERRY |
| Zip Code | 05148 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.