Provider Demographics
NPI:1285026583
Name:PECK, LESTER GALE (RPH, PHARM D)
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:GALE
Last Name:PECK
Suffix:
Gender:M
Credentials:RPH, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CHESTER RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-2957
Mailing Address - Country:US
Mailing Address - Phone:802-885-5311
Mailing Address - Fax:802-885-9330
Practice Address - Street 1:2 CHESTER RD
Practice Address - Street 2:SUITE 25
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-2957
Practice Address - Country:US
Practice Address - Phone:802-885-5311
Practice Address - Fax:802-885-9330
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0003417183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist