| NPI | 1144421322 |
|---|---|
| Doing Business As | ISLAND POND HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | MICHAEL COSTA CEO 802-748-9405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2019-09-16 |