| NPI | 1164542361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK BURKE Federal Programs Administrator 802-863-7257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2008-07-30 |