Provider Demographics
NPI:1588117329
Name:BOGAN, BRITTANY (DOCTOR OF PHARMACY)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BOGAN
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 1/2 POND ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3900
Mailing Address - Country:US
Mailing Address - Phone:978-462-5339
Mailing Address - Fax:
Practice Address - Street 1:39 HINESBURG RD
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6526
Practice Address - Country:US
Practice Address - Phone:802-882-5722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0119964183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist