| NPI | 1730336843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW J MAJKA CFO 802-886-8950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 208M00000X Hospitalist | |
| 261QR1300X Clinic/Center, Rural Health | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2024-10-31 |