Brian Bruyns
Individual provider Active NPI Pharmacist · Williston, VT
NPI 1386936540 · NPPES record last updated May 6, 2011
Key facts
- NPI
- 1386936540
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 3314 (VT)
- Practice address
- 600 Blair Park Rd
Suite 195
Williston, VT 05495-7586 - Phone
- (802) 878-9116
- NPI assigned
- May 6, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3314 | VT | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3314 | VT | Yes |
Addresses
Primary practice location
600 Blair Park Rd
Suite 195
Williston, VT 05495-7586
Mailing address
3 Raymond Dr
Essex Junction, VT 05452-3867
Other providers in Williston, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2011. 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.