Ty Macwalters, CPHT Valid NPI

Individual provider · Institutional Pharmacy · Berlin, VT

NPI

1679095475

Type

Individual (Type 1)

Primary specialty

Institutional Pharmacy (Pharmacy)

Specialty group

Suppliers

Taxonomy code

3336I0012X

License number

037.0001187 (VT)

Sex

Male

Sole proprietor

Yes

Enumerated

2017-07-13

Last updated

2018-03-17