# COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** CHCRR Pediatrics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780969345
- **Authorized official:** MICHAEL GARDNER (FINANCE DIRECTOR)
- **Authorized official phone:** (802) 855-2083

## Contact information

- **Practice address:** 1 GENERAL WING RD, RUTLAND, VT 05701-4681
- **Practice address phone:** (802) 773-9131
- **Practice address fax:** (802) 773-1551
- **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 |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |
| 261QF0400X | Federally Qualified Health Center (FQHC) | — | NULL | — |

## Other

- **Enumeration date:** 10/14/2011
- **Last updated:** 01/18/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 03891774 | — | NY |
| 05 | — | 0471842 | — | VT |
| 05 | — | 1019786 | — | VT |