# NORTHWESTERN MEDICAL CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northwestern Medical Center/Georgia Health Care, Northwestern Georgia Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417287665
- **Authorized official:** MARY E PIGEON (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (802) 524-8954

## Contact information

- **Practice address:** 4178 HIGHBRIDGE RD, FAIRFAX, VT 05454-5446
- **Practice address phone:** (802) 752-1930
- **Practice address fax:** (802) 524-2867
- **Mailing address:** 133 FAIRFIELD ST, SAINT ALBANS, VT 05478-1726
- **Mailing address phone:** (802) 524-5911
- **Mailing address fax:** (802) 524-7021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/12/2010
- **Last updated:** 10/26/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1017250 | — | VT |