| NPI | 1073567590 |
|---|---|
| Former Legal Business Name | DBA BRANDON MEDICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | MICHAEL GARDNER Finance Director 802-855-2083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2018-09-11 |