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Organization

COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC.

Active
Other names
dba Mettowee Valley Family Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL L GARDNER (FINANCE DIRECTOR)
(802) 855-2080
Entity
Organization

Contact information

Practice address
278 VT ROUTE 149, WEST PAWLET, VT 05775-9798
(802) 645-0580
(802) 645-0587
Mailing address
71 ALLEN ST, SUITE 403, RUTLAND, VT 05701-4570
(802) 772-4414
(802) 772-7973

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
261QF0400X
Federally Qualified Health Center (FQHC)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03044048
NY
05
1010850
VT
01
471816
NAT'L GOV SERVICES
VT
Enumeration date
05/19/2006
Last updated
09/11/2018
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