Green Mountain Medical Store LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GREEN MOUNTAIN MEDICAL STORE LLC

Practice address

46 Fox Run Rd
Essex Junction, VT 05452-2653

Phone

(802) 598-2697

NPI assigned

Sep 6, 2018

Last updated

Sep 6, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mitali R Asher

Title

Authorized Official

Phone

(802) 598-2697

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536192000000",
    "number": "1235612169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 FOX RUN RD",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054522653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 FOX RUN RD",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054522653",
            "telephone_number": "802-598-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN MOUNTAIN MEDICAL STORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-06",
        "last_updated": "2018-09-06",
        "status": "A",
        "authorized_official_last_name": "ASHER",
        "authorized_official_first_name": "MITALI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "802-598-2697"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ira Kenneth Glasser, LCSW; LICSW
• June E Golato, M.S.
• Golden Love Home Care
• Alice D Goodrich, MSPT
• Stephen Gorman, M.D.
• Zoe Holiday Grossman
• Esther Elizabeth Halden, PT
• Jessica M Hall, ATC
• Oliver D F Hall, PT
• Hannah Engelken LLC

• Durable Medical Equipment & Medical Supplies in Essex Junction, VT
• Providers in Essex Junction, VT by specialty
• Durable Medical Equipment & Medical Supplies in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; 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.