Organization
HOPE MEDICAL CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN F DUMAS NP (OWNER)
(802) 773-7502
Entity
Organization
Contact information
Practice address
92 ALLEN ST, RUTLAND, VT 05701-4562
(802) 773-7502
(802) 773-7022
Mailing address
92 ALLEN ST, RUTLAND, VT 05701-4562
(802) 773-7502
(802) 773-7022
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
1010015655
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0025803
MEDICARE PTAN
VT
05
—
1008529
—
VT
01
—
1020249
MEDICAID FOR HOPE MEDICAL CLINIC
VT
01
—
47D2040632
CLIA WAIVER
—
01
—
5501740
MVP
VT
Enumeration date
12/31/2011
Last updated
04/17/2017
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