# COLD HOLLOW FAMILY PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902064496
- **Authorized official:** CANDACE M COLLINS (CLINIC ADMINISTRATOR)
- **Authorized official phone:** (802) 933-6664

## Contact information

- **Practice address:** 84 WATER TOWER RD, SUITE 1, ENOSBURG FALLS, VT 05450-6097
- **Practice address phone:** (802) 933-6664
- **Practice address fax:** (802) 933-8333
- **Mailing address:** 84 WATER TOWER RD, SUITE 1, ENOSBURG FALLS, VT 05450-6097
- **Mailing address phone:** (802) 933-6664
- **Mailing address fax:** (802) 933-8333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/30/2008
- **Last updated:** 05/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1014837 | — | VT |