NPI 1104870922 · live from the CMS NPI Registry
Community Health Centers Of The Rutland Region, INC.
Family Medicine in West Pawlet, VT. National Provider Identifier 1104870922, active.
NPI record
| NPI | 1104870922 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 278 Vt Route 149, West Pawlet, VT 05775 |
| Practice phone | 802-645-0580 |
| Mailing address | 71 Allen St, Suite 403, Rutland, VT 05701 |
| Enumerated | May 19, 2006 |
| Last updated | September 11, 2018 |
| Authorized official | Michael Gardner, Finance Director |
| Other names | Dba Mettowee Valley Family Health 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.