Provider Demographics
NPI:1962818781
Name:WELCH, ANDREA LOUISE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LOUISE
Last Name:WELCH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:LOUISE
Other - Last Name:GALLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:969 POST RD
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-0989
Mailing Address - Country:US
Mailing Address - Phone:802-558-0559
Mailing Address - Fax:
Practice Address - Street 1:1 RUTLAND SHOPPING PLAZA
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701
Practice Address - Country:US
Practice Address - Phone:802-773-1600
Practice Address - Fax:802-773-0269
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24105183500000X
VT033.0105811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist