MEDICARE: RUTLAND 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1457530792
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUTLAND PHARMACY INC

Provider Business Mailing Address
First Line	:	PO BOX 233
Second Line	:
City	:	RUTLAND
State	:	MA
Zip	:	01543-0233
Country	:	US
Telephone Number	:	508-886-6261
Fax Number	:	508-886-2443

Provider Business Practice Location Address
First Line	:	18 MAPLE AVE
Second Line	:
City	:	RUTLAND
State	:	MA
Zip	:	01543-0233
Country	:	US
Telephone Number	:	508-886-6261
Fax Number	:	508-886-2443

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID TUTTLE
Credential	:
Telephone Number	:	508-886-6261

Provider Enumeration Date	:	11/02/2007
Last Update Date	:	11/02/2007

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Directions to “RUTLAND PHARMACY INC ” Practice Location

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