Organization Active NPI

Beauchamp & O'Rourke Inc.

  • Community/Retail Pharmacy
  • Rutland, VT
National Provider Identifier
1346285921
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0380000553 Issued in VT
Legal business name
BEAUCHAMP & O'ROURKE INC.
Practice address
62 Woodstock Ave Ste 1
Rutland, VT 05701-3534
Phone
(802) 775-4321
Fax
(802) 775-8211
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Barry Scott Beauchamp
Title
Store Manager
Phone
(802) 775-4321

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 0380000553 VT Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

62 Woodstock Ave Ste 1
Rutland, VT 05701-3534

Mailing address

62 Woodstock Ave Ste 1
Rutland, VT 05701-3534
Phone (802) 775-4321

Other identifiers 2

IdentifierTypeStateIssuer
0007170MedicaidVT
4700185OtherVTNABP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150904001174 VT Part B Supplier - Mass Immunization (Roster Biller Only) 2365569779 Practice locations: Rutland, VT

National Provider Directory

National Provider Directory

Locations

62 Woodstock Ave
Ste 1
Rutland, VT 05701
Phone (802) 775-4321

62 Woodstock Ave
Rutland, VT 05701
Phone (802) 775-2660

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1346285921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 WOODSTOCK AVE STE 1",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057013534",
            "telephone_number": "802-775-4321",
            "fax_number": "802-775-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 WOODSTOCK AVE STE 1",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057013534",
            "telephone_number": "802-775-4321",
            "fax_number": "802-775-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUCHAMP & O'ROURKE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "BEAUCHAMP",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "STORE MANAGER",
        "authorized_official_telephone_number": "802-775-4321",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VT",
            "license": "0380000553",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007170",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4700185",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.