Provider Demographics
NPI:1932624764
Name:GILCREAST, FRANK DEMOND III (PHARMACIST)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:DEMOND
Last Name:GILCREAST
Suffix:III
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ALDER LN
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4903
Mailing Address - Country:US
Mailing Address - Phone:207-710-8030
Mailing Address - Fax:
Practice Address - Street 1:800 US ROUTE 302
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-2382
Practice Address - Country:US
Practice Address - Phone:802-476-6659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2022-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0129762183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT033.0129762OtherVERMONT BOARD OF PHARMACY