# SOUTH HERO PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Hero Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790866010
- **Authorized official:** AUDREY MCGREGOR REARDON (PRES)
- **Authorized official phone:** (802) 655-3544

## Contact information

- **Practice address:** 334 US ROUTE 2, SOUTH HERO, VT 05486
- **Practice address phone:** (802) 372-5377
- **Practice address fax:** (802) 372-5638
- **Mailing address:** PO BOX 277, 334 US ROUTE 2, SOUTH HERO, VT 05486
- **Mailing address phone:** (802) 372-5377
- **Mailing address fax:** (802) 372-5638

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 0380003129 | VT | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 09/04/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0007138 | — | VT |
| 01 | — | 4703129 | OTHER ID NUMBER | — |