NPI 1073567590 · live from the CMS NPI Registry
Community Health Centers Of The Rutland Region, INC.
Family Medicine in Brandon, VT. National Provider Identifier 1073567590, active.
NPI record
| NPI | 1073567590 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 420 Grove St, Brandon, VT 05733 |
| Practice phone | 802-247-6305 |
| Mailing address | 71 Allen St, Suite 101, Rutland, VT 05701 |
| Enumerated | May 20, 2006 |
| Last updated | September 11, 2018 |
| Authorized official | Michael Gardner, Finance Director |
| Other names | Dba Brandon Medical Center |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center, Federally Qualified Health Center (FQHC) | 261QF0400X | — |
| Family Medicine primary | 207Q00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.