Niklas-Moore Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

0380003348 Issued in VT

Legal business name

NIKLAS-MOORE INC

Practice address

5700 RT 100 Unit C-10
Londonderry, VT 05148-0576

Phone

(802) 824-3344

Fax

(802) 824-3332

NPI assigned

Jul 25, 2006

Organization subpart

No

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

Authorized official

Name

Sara Kay Niklas, PHARMD RPH

Title

Owner Manager

Phone

(802) 824-3344

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Green Mountain Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184646192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 RT 100 UNIT C-10",
            "address_2": "PO BOX 576",
            "city": "LONDONDERRY",
            "state": "VT",
            "postal_code": "051480576",
            "telephone_number": "802-824-3344",
            "fax_number": "802-824-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 RT 100 UNIT C-10",
            "city": "LONDONDERRY",
            "state": "VT",
            "postal_code": "051480576",
            "telephone_number": "802-824-3344",
            "fax_number": "802-824-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIKLAS-MOORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NIKLAS",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER MANAGER",
        "authorized_official_telephone_number": "802-824-3344",
        "authorized_official_credential": "PHARMD RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "VT",
            "license": "0380003348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011164",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Mountain Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacist in Londonderry, VT
• Providers in Londonderry, VT by specialty
• Pharmacist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.