Ryan Conlon Bushey, RPH
Individual provider Active NPI Pharmacist · Burlington, VT
NPI 1104149913 · NPPES record last updated Sep 16, 2024
Key facts
- NPI
- 1104149913
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 054238-1 (NY)
- Practice address
- 1 S Prospect St
Burlington, VT 05401-3456 - Phone
- (802) 847-3353
- Fax
- (802) 847-3301
- NPI assigned
- Mar 8, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054238-1 | NY | MD | Pharmacist |
| 033.0047423 | VT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martins Foods of South Burlington LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 033.0047423 | VT | |
| Pharmacist | 183500000X | 054238-1 | NY | Yes |
Addresses
Primary practice location
1 S Prospect St
Burlington, VT 05401-3456
Mailing address
230 Brennan Woods Dr
Williston, VT 05495-8902
Phone (802) 734-8319
Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.