Provider Demographics
NPI:1417550294
Name:FOLEY, HEATHER A
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:FOLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 FLETCHER RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:VT
Mailing Address - Zip Code:05444-9616
Mailing Address - Country:US
Mailing Address - Phone:802-682-6422
Mailing Address - Fax:
Practice Address - Street 1:164 SWANTON RD
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-2601
Practice Address - Country:US
Practice Address - Phone:802-524-6543
Practice Address - Fax:802-524-7269
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2024-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0130047183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT033.0130047OtherPHARMACIST LICENSE