Healthcare Provider Details

I. General information

NPI: 1740071562
Provider Name (Legal Business Name): RUTLAND FAMILY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MAPLE AVE
RUTLAND MA
01543-1529
US

IV. Provider business mailing address

PO BOX 3
RUTLAND MA
01543-0003
US

V. Phone/Fax

Practice location:
  • Phone: 508-361-0508
  • Fax:
Mailing address:
  • Phone: 508-361-0508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. DAVID BECK
Title or Position: PHARMACIST / CO-OWNER
Credential: RPH
Phone: 508-361-0508