Organization
SUGAR RIVER PHARMACY LLC
Active
Other names
Sugar River Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHAD BEANE BS, MBA (PHARMACY MANAGER)
(603) 863-4111
Entity
Organization
Contact information
Practice address
54 JOHN STARK HWY, NEWPORT, NH 03773-1811
(603) 863-4111
(603) 863-4533
Mailing address
54 JOHN STARK HWY, NEWPORT, NH 03773-1811
(603) 863-4111
(603) 863-4533
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0763
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2122307
PK
—
Enumeration date
10/08/2009
Last updated
11/14/2021
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