Maxi Green Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

380003322 Issued in VT

Legal business name

MAXI GREEN INC

Practice address

52 Main Street
Windsor, VT 05089-1308

Phone

(802) 674-2789

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer Zorek

Title

Manager Online Adjudication

Phone

(717) 975-5937

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• RITE AID PHARMACY 10310 Doing business as

Locations

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334102400000",
    "number": "1376559583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEWBERRY COMMONS",
            "city": "ETTERS",
            "state": "PA",
            "postal_code": "173199363",
            "telephone_number": "717-761-2633",
            "fax_number": "717-975-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 MAIN STREET",
            "city": "WINDSOR",
            "state": "VT",
            "postal_code": "050891308",
            "telephone_number": "802-674-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXI GREEN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2012-04-11",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER ONLINE ADJUDICATION",
        "authorized_official_telephone_number": "717-975-5937"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VT",
            "license": "380003322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007837",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4703826",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 10310",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alan Lovell, BA
• Patrick Lyons, PA
• Katherine A Macko, PAC
• Richard A Marasa, MD
• Shona Marston, BCBA
• Lauren D McClure, MD
• Ryan Russell McCool, M.D.
• Nancy M McCullough, RN,CDE
• Karen D McGinty, LICSW
• Jeremy C McWhorter, PA-C

• All providers in Windsor, VT
• Community/Retail Pharmacy in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; 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.