Provider Demographics
NPI:1508145137
Name:ALTER, MATT M (RPH)
Entity type:Individual
Prefix:
First Name:MATT
Middle Name:M
Last Name:ALTER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 SWANTON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-2601
Mailing Address - Country:US
Mailing Address - Phone:802-524-6543
Mailing Address - Fax:802-524-7269
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:802-524-5656
Practice Address - Fax:802-524-7269
Is Sole Proprietor?:No
Enumeration Date:2011-08-13
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0330003411183500000X
VT033.0003411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist