Provider Demographics
NPI:1538310289
Name:JMS PHARMACY MANAGEMENT INC
Entity Type:Organization
Organization Name:JMS PHARMACY MANAGEMENT INC
Other - Org Name:CASTLETON HEALTH CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-236-4154
Mailing Address - Street 1:275 ROUTE 30 N
Mailing Address - Street 2:
Mailing Address - City:BOMOSEEN
Mailing Address - State:VT
Mailing Address - Zip Code:05732-9647
Mailing Address - Country:US
Mailing Address - Phone:802-468-5800
Mailing Address - Fax:802-468-5811
Practice Address - Street 1:275 ROUTE 30 N
Practice Address - Street 2:
Practice Address - City:BOMOSEEN
Practice Address - State:VT
Practice Address - Zip Code:05732-9647
Practice Address - Country:US
Practice Address - Phone:802-468-5800
Practice Address - Fax:802-468-5811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.00026313336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2117390OtherPK
4704309OtherNCPDP PROVIDER IDENTIFICATION NUMBER