Organization
COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC
Active
Other names
Common Street Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GRANT L WHITMER JR. (EXECUTIVE DIRECTOR)
(802) 468-5641
Entity
Organization
Contact information
Practice address
4 COMMONS ST, RUTLAND, VT 05701-4651
(802) 773-1321
Mailing address
4 COMMONS ST, RUTLAND, VT 05701-4651
(802) 773-1321
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0471838
—
VT
Enumeration date
12/16/2010
Last updated
08/10/2011
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