Provider Demographics
NPI:1689281495
Name:HEAL, ADRIAN L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:L
Last Name:HEAL
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 1:114 OLD STAGE RD
Mailing Address - Street 2:
Mailing Address - City:PUTNEY
Mailing Address - State:VT
Mailing Address - Zip Code:05346-8609
Mailing Address - Country:US
Mailing Address - Phone:802-275-8267
Mailing Address - Fax:
Practice Address - Street 1:114 OLD STAGE RD
Practice Address - Street 2:
Practice Address - City:PUTNEY
Practice Address - State:VT
Practice Address - Zip Code:05346-8609
Practice Address - Country:US
Practice Address - Phone:802-275-8267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0120592183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist