KELLEY PHARMACY INC (NPI# 1366578114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366578114 |
| Entity Type | Organization |
| Organization Name | KELLEY PHARMACY INC |
| Other Organization Name | CUSTOM PRESCRIPTION SHOPPE |
| Practice Address |
42 Timber Ln South Burlington VT 05403-7204 |
| Practice Telephone | 8028640812 |
| Mailing Telephone | 8028640812 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. SCOTT WILLIAM BROWN III (OWNER PHARMACIST) |
| Authorized Official Telephone | 8028640812 |
| Authorized Official Credential | R.PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 038-0002622 | VT | Suppliers |
| Other Name | Type Code |
|---|---|
| Custom Prescription Shoppe | Doing Business As Name - Organization |
| Street Address |
42 TIMBER LN |
| City | SOUTH BURLINGTON |
| State | VT |
| Zip Code | 05403-7204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912469297 | Green Mountain Pediatric Dentistry, Pllc | Dentist | 42 Timber Ln, South Burlington, VT 05403-7204 | 2019-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659938975 | Josee-ann Guay | Student in an Organized Health Care Education/Training Program | 1060 Hinesburg Road Suite 201, South Burlington, VT 05403 | 2019-05-22 |
| 1821556390 | Alexander Taite Carpenter | Specialist/Technologist | 2069 Williston Road Ap #2, South Burlington, VT 05403 | 2019-03-04 |
| 1144732785 | Molly Koch Parker | Dietitian, Registered | 1233 Shelburne Rd Ste D2, South Burlington, VT 05403 | 2017-11-03 |
| 1497273007 | Marlena Anya Pecora | Acupuncturist | 368 Dorset St # 3, South Burlington, VT 05403 | 2017-09-03 |
| 1467908525 | Rinaben P Patel | Pharmacist | 39 Hinesburd Road, South Burlington, VT 05403 | 2016-08-29 |
| 1770949950 | Tara Flor | Chiropractor | 30 Farrell St Ste 100, South Burlington, VT 05403 | 2016-01-04 |
| 1356716187 | Frank Breen | Counselor | 163 Hinesburg Road, South Burlington, VT 05403 | 2015-12-04 |
| 1063808210 | Lisa C Harrington | Registered Nurse | Stone House Associates, 27 Rye Circle, South Burlington, VT 05403 | 2015-04-14 |
| 1083018626 | Jessica Jablonski | Speech-Language Pathologist | 2 Baldwin Ave, South Burlington, VT 05403 | 2014-10-10 |
| 1538590567 | Vasta Physical Therapy, Inc | Physical Therapist | 340 Dorset Street, Suite 2, South Burlington, VT 05403 | 2013-12-02 |
| Find all providers in zip 05403 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316054596 | Kph Healthcare Services, Inc. | Pharmacy | 1653 Williston Rd, South Burlington, VT 05403-6426 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316455256 | Genoa Healthcare, LLC | Pharmacy | 72 Harrel St Ste A03, Morrisville, VT 05661-8526 | 2018-01-12 |
| 1497264899 | Chelsea Pharmacy LLC | Pharmacy | 356 Vt-110, Chelsea, VT 05038 | 2017-09-28 |
| 1821359282 | Pharmacy Health Services Inc | Pharmacy | 61 Pine St Ste 401, Bristol, VT 05443-1043 | 2012-06-01 |
| 1023312964 | Ludlow Pharmacy Inc | Pharmacy | 57 Pond St, Ludlow, VT 05149-1083 | 2011-01-07 |
| 1295044840 | Smith & Peck Pharmacy Management Services Inc | Pharmacy | 242 River St, Springfield, VT 05156-2306 | 2010-09-30 |
| 1972648129 | The Drug Store Inc | Pharmacy | Village Square, Suite 7, Waitsfield, VT 05673-0391 | 2007-02-21 |
| 1124166624 | Jo-mar Inc. | Pharmacy | 921 Us Rt 302, Barre, VT 05641-4465 | 2007-02-05 |
| 1427112861 | University of Vermont Medical Center Inc | Pharmacy | 111 Colchester Ave # Mp3, Burlington, VT 05401-1473 | 2006-12-20 |
| 1669549150 | Browns Drug Store | Pharmacy | 40 Main, Derby Line, VT 05830 | 2006-11-29 |
| 1396829420 | Northfield Pharmacy Inc | Pharmacy | 14 Depot Sq, Northfield, VT 05663-6958 | 2006-10-25 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BURLINGTON |
| Zip Code | 05403 |
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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.