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Organization
COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC.
Active
Organization
COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC.
Active
Other names
CHCRR Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GARDNER (FINANCE DIRECTOR)
(802) 855-2083
Entity
Organization
Contact information
Practice address
1 GENERAL WING RD, RUTLAND, VT 05701-4681
(802) 773-9131
(802) 773-1551
Mailing address
71 ALLEN ST, SUITE 101, RUTLAND, VT 05701-4570
(800) 468-9118
(802) 772-7973
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
NULL
208000000X
Pediatrics Physician
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03891774
—
NY
05
—
0471842
—
VT
05
—
1019786
—
VT
Enumeration date
10/14/2011
Last updated
01/18/2017
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