# RIVER STREET PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** River Street Pharmacy Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093075145
- **Authorized official:** JASON HOCHBERG (OWNER)
- **Authorized official phone:** (802) 775-2545

## Contact information

- **Practice address:** 100 RIVER ST, UNIT 203, SPRINGFIELD, VT 05156-2930
- **Practice address phone:** (802) 885-6800
- **Practice address fax:** (802) 885-6804
- **Mailing address:** 100 RIVER ST, UNIT 203, SPRINGFIELD, VT 05156-2930
- **Mailing address phone:** (802) 885-6800
- **Mailing address fax:** (802) 885-6804

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 038.0087228 | VT | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 05/23/2012
- **Last updated:** 02/16/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1021209 | — | VT |
| 01 | — | 2135636 | PK | — |