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Organization
NORTHERN COUNTIES HLTH CARE INC
Active
Organization
NORTHERN COUNTIES HLTH CARE INC
Active
Other names
ISLAND POND HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JACK DONNELLY (DIR OF OPERATIONS)
(802) 748-9405
Entity
Organization
Contact information
Practice address
82 MAPLE STREET, ISLAND POND, VT 05846-0425
(802) 723-4300
(802) 723-4544
Mailing address
PO BOX 425, ISLAND POND, VT 05846-0425
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007175
—
VT
01
—
4703270
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/24/2006
Last updated
08/22/2020
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