MEDICARE: WOODSTOCK PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	0380001175	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2101268	OTHER		PK

General Provider Information

NPI Number	:	1023115862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODSTOCK PHARMACY INC

Provider Business Mailing Address
First Line	:	19 CENTRAL ST
Second Line	:
City	:	WOODSTOCK
State	:	VT
Zip	:	05091-1005
Country	:	US
Telephone Number	:	802-457-1306
Fax Number	:	802-457-3246

Provider Business Practice Location Address
First Line	:	19 CENTRAL ST
Second Line	:
City	:	WOODSTOCK
State	:	VT
Zip	:	05091-1005
Country	:	US
Telephone Number	:	802-457-1306
Fax Number	:	802-457-3246

Authorized Official
Title or Position	:	PHARM AND MGR
Name	:	JAMES MARMAR
Credential	:	RPH
Telephone Number	:	802-457-1306

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	09/19/2025

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Directions to “WOODSTOCK PHARMACY INC ” Practice Location

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