# ST JAY PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** dba Wells River Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114082153
- **Authorized official:** MR. DENNIS HENRY STRAIGHT (OWNER)
- **Authorized official phone:** (802) 757-2244

## Contact information

- **Practice address:** 41 MAIN ST N., WELLS RIVER, VT 05081-0672
- **Practice address phone:** (802) 757-2244
- **Mailing address:** PO BOX 672, WELLS RIVER, VT 05081-0672
- **Mailing address phone:** (802) 757-2244

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 0380003329 | VT | Yes |

## Other

- **Enumeration date:** 12/27/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1008262 | — | VT |
| 05 | — | 30701654 | — | NH |