Provider Demographics
NPI:1609764232
Name:RIVER RUN PHARMACIES, INC
Entity type:Organization
Organization Name:RIVER RUN PHARMACIES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:JACHTHUBER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:608-297-7452
Mailing Address - Street 1:120 UNDERWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MONTELLO
Mailing Address - State:WI
Mailing Address - Zip Code:53949-9354
Mailing Address - Country:US
Mailing Address - Phone:608-297-2474
Mailing Address - Fax:608-716-3159
Practice Address - Street 1:120 UNDERWOOD AVE
Practice Address - Street 2:
Practice Address - City:MONTELLO
Practice Address - State:WI
Practice Address - Zip Code:53949-9354
Practice Address - Country:US
Practice Address - Phone:608-297-2474
Practice Address - Fax:608-716-3159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-24
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care