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General NPI Number Information
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NPI Number | 1407447014
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Entity Type | Organization
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Legal Business Name | OTTAUQUECHEE PHARMACY INC
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 32 PLEASANT ST
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City | WOODSTOCK
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State | VT
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Zip | 05091-1122
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Country | US
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Telephone | 802-775-2545
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Fax |
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Provider Business Mailing Address
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Address Line | 75 ALLEN ST
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City | RUTLAND
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State | VT
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Zip | 05701-4501
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Country | US
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Telephone | 802-775-2545
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | STEVEN HOCHBERG
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Credential | RPH
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Telephone | 802-775-2545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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