Provider Demographics
NPI:1336744697
Name:PEASE, CATHY SCOVELL (RPH)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:SCOVELL
Last Name:PEASE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 WRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-4419
Mailing Address - Country:US
Mailing Address - Phone:802-872-8840
Mailing Address - Fax:802-872-8841
Practice Address - Street 1:49 WRIGHT AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-4419
Practice Address - Country:US
Practice Address - Phone:802-872-8840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT33-00002780183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist