Provider Demographics
NPI:1326491556
Name:KAUSCH, KENNETH (PHARMD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:KAUSCH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-1380
Mailing Address - Country:US
Mailing Address - Phone:802-655-2444
Mailing Address - Fax:
Practice Address - Street 1:13 BORESTONE LN
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05408-1841
Practice Address - Country:US
Practice Address - Phone:860-965-6741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-23
Last Update Date:2016-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0118832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist