# BROOKSIDE FAMILY HEALTH CENTER, PLLC

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

## Provider details

- **NPI number:** 1952702219
- **Authorized official:** DR. ROGER JOSEPH GIROUX M.D. (OWNER)
- **Authorized official phone:** (802) 482-3900

## Contact information

- **Practice address:** 206 COMMERCE ST, HINESBURG, VT 05461-0416
- **Practice address phone:** (802) 482-3900
- **Practice address fax:** (802) 482-4159
- **Mailing address:** PO BOX 416, 206 COMMERCE ST, HINESBURG, VT 05461-0416
- **Mailing address phone:** (802) 482-3900
- **Mailing address fax:** (802) 482-4159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 42-0008119 | VT | Yes |

## Other

- **Enumeration date:** 09/05/2014
- **Last updated:** 09/05/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9210 | — | VT |