MEDICARE: VERMONT FAMILY 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	0380002317	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	2101400	OTHER		PK

General Provider Information

NPI Number	:	1457455420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERMONT FAMILY PHARMACY INC

Provider Business Mailing Address
First Line	:	1219 NORTH AVE
Second Line	:
City	:	BURLINGTON
State	:	VT
Zip	:	05408-2747
Country	:	US
Telephone Number	:	802-658-9664
Fax Number	:	802-658-3172

Provider Business Practice Location Address
First Line	:	1219 NORTH AVE
Second Line	:
City	:	BURLINGTON
State	:	VT
Zip	:	05408-2747
Country	:	US
Telephone Number	:	802-658-9664
Fax Number	:	802-658-3172

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MATTHEW B O'CONNOR
Credential	:	RPH
Telephone Number	:	802-658-9664

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	10/24/2025

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