MEDICARE: CANAL STREET PHARMACY, LLC

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1356294748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANAL STREET PHARMACY, LLC

Provider Business Mailing Address
First Line	:	78 ATKINSON ST
Second Line	:
City	:	BELLOWS FALLS
State	:	VT
Zip	:	05101-1321
Country	:	US
Telephone Number	:	802-428-4023
Fax Number	:	866-859-1169

Provider Business Practice Location Address
First Line	:	447 CANAL ST
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301-6619
Country	:	US
Telephone Number	:	802-428-4023
Fax Number	:	866-859-1169

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MARC P COTE
Credential	:	R.PH.
Telephone Number	:	802-779-5774

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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