Healthcare Provider Details

I. General information

NPI: 1235168485
Provider Name (Legal Business Name): SPRINGFIELD PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 RIVER ST
SPRINGFIELD VT
05156-2306
US

IV. Provider business mailing address

262 RIVER ST
SPRINGFIELD VT
05156-2306
US

V. Phone/Fax

Practice location:
  • Phone: 802-885-6400
  • Fax: 802-885-6415
Mailing address:
  • Phone: 802-885-6400
  • Fax: 802-885-6415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0380003324
License Number StateVT
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: STEVE HOCHBERG
Title or Position: OWNER,RPH,AO
Credential:
Phone: 802-775-2545