# COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** dba Brandon Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073567590
- **Authorized official:** MICHAEL GARDNER (FINANCE DIRECTOR)
- **Authorized official phone:** (802) 855-2083

## Contact information

- **Practice address:** 420 GROVE ST, BRANDON, VT 05733-9062
- **Practice address phone:** (802) 247-6305
- **Practice address fax:** (802) 247-6040
- **Mailing address:** 71 ALLEN ST, SUITE 101, RUTLAND, VT 05701-4570
- **Mailing address phone:** (800) 468-9118
- **Mailing address fax:** (802) 772-7973

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QF0400X | Federally Qualified Health Center (FQHC) | — | NULL | — |

## Other

- **Enumeration date:** 05/20/2006
- **Last updated:** 09/11/2018