River Run Pharmacies, Inc
Organization Active NPI Community/Retail Pharmacy · Montello, WI
NPI 1093889396 · NPPES record last updated Aug 20, 2025
Key facts
- NPI
- 1093889396
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 4820-42 (WI)
- Legal business name
- RIVER RUN PHARMACIES, INC
- Practice address
- 120 Underwood Ave
Montello, WI 53949-9354 - Phone
- (608) 297-2474
- Fax
- (608) 716-3159
- NPI assigned
- Nov 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Eric D Jachthuber, PHARMD
- Title
- Owner
- Phone
- (608) 297-7452
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 3
Practitioners 2
-
Eric D Jachthuber, PHARMD
-
Trisha Shead, PHARM D
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| River Run Pharmacies Inc |
Immunosuppressive Drugs|Nebulizer Drugs | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240405002039 | WI | Part B Supplier - Mass Immunization (Roster Biller Only) | 0042658379 |
2 other NPIs on this enrollment Practice locations: Montello, WI; Westfield, WI; Princeton, WI |
| O20241123000226 | WI | DME Supplier - Pharmacy | 0042658379 | Practice locations: Montello, WI |
National Provider Directory
- Tax ID family
- River Run Pharmacies Inc
Locations
120 Underwood Ave
Montello, WI 53949
Phone (608) 297-2474
25 W Montello St
Montello, WI 53949
Phone (608) 297-2474
206 S Main St
Westfield, WI 53964
Phone (608) 296-2877
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 4820-42 | WI | Yes |
Addresses
Primary practice location
120 Underwood Ave
Montello, WI 53949-9354
Mailing address
120 Underwood Ave
Montello, WI 53949-9354
Phone (608) 297-2474
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093889396 | Medicaid | WI |
Other names
- Central Wisconsin Pharmacy -Montello
Other providers in Montello, WI
- Sara M. McNamara
- Mikayla Mlsna
- Montello Joint Fire District
- Montello School District
- Irene E Quandt
- River Run Pharmacies, Inc
- Annette Schlagenhaft
- Tiffany Schmit
- Tanya Schonasky
- Trisha Shead
All providers in Montello, WI · Community/Retail Pharmacy in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.