Mountainside Pharmacy Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

MOUNTAINSIDE PHARMACY INC

Practice address

45 Old Farm Rd
Stowe, VT 05672

Phone

(802) 760-6262

NPI assigned

May 1, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kyle Maxwell

Title

Owner

Phone

(802) 760-6262

Specialties & licenses 1

Addresses

Tax ID family

Mountainside Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mountainside Pharmacy Inc

  • Community/Retail Pharmacy
  • Stowe, VT
  • NPI 1346952678
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laura Demarse, PHARMD

  • Pharmacist
  • Stowe, VT
  • NPI 1548147218
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1003663808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 OLD FARM RD",
            "city": "STOWE",
            "state": "VT",
            "postal_code": "05672",
            "telephone_number": "802-760-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 OLD FARM RD",
            "city": "STOWE",
            "state": "VT",
            "postal_code": "05672",
            "telephone_number": "802-760-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINSIDE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-760-6262"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Mannino
• Katherine Gamble Marvin, MD
• Brenna McGrath
• Jeffrey R McKechnie, DMD
• Tessa C.V. Milnes, D.D.S.
• Mountainside Pharmacy Inc
• Moving Forward Physical Therapy
• Myeyedr Optometry of Vermont LLC
• Lara Nargozian, ND, LAC
• Noonan Physical Therapy, PC

• Long Term Care Pharmacy in Stowe, VT
• Providers in Stowe, VT by specialty
• Long Term Care Pharmacy in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.