JACK SULLIVAN
NPI 1104631399
Pharmacist in Woodsville, NH

Active since February 12, 2025
4901 DARTMOUTH COLLEGE HWY, WOODSVILLE, NH 03785(603) 747-3355 Get Directions Write a Review

NPPES record last updated: March 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 24, 2025, Feb 12, 2025 (2 updates tracked since 2025).

About Jack Sullivan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK SULLIVAN (NPI 1104631399) is an individual pharmacist in Woodsville, New Hampshire, licensed in New Hampshire (PHCY-05103) and active in the NPI registry since February 2025.

NPPES Registry Identity

NPI1104631399
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameJACK SULLIVAN
Location Address4901 DARTMOUTH COLLEGE HWYWoodsville, NH 03785-1412
Mailing Address102 Highland AveSaint Johnsbury, VT 05819-2577 · (603) 723-3016
Sole ProprietorYes
Enumeration DateFebruary 12, 2025
Last NPPES UpdateMarch 24, 20252 updates tracked since enumeration
NPPES CertifiedMarch 24, 2025
NPI 1104631399 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in NH · PHCY-05103
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
4901 DARTMOUTH COLLEGE HWY, Woodsville, NH 03785

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
4901 DARTMOUTH COLLEGE HWY
WOODSVILLE, NH 03785
Pharmacy (Community/Retail Pharmacy)
4901 DARTMOUTH COLLEGE HWY
WOODSVILLE, NH 03785

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Sullivan's NPI number?

The NPI number for Jack Sullivan is 1104631399. It was assigned to this individual provider in the NPPES registry on February 12, 2025.

Where is Jack Sullivan located?

Jack Sullivan practices at 4901 Dartmouth College Hwy, Woodsville, NH 03785. The listed phone number is (603) 747-3355.

What is Jack Sullivan's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Jack Sullivan was last updated on March 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.