Organization
COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC.
Active
Other names
dba Castleton Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL L GARDNER (FINANCE DIRECTOR)
(802) 855-2080
Entity
Organization
Contact information
Practice address
275 ROUTE 30 N, BOMOSEEN, VT 05732-9647
(802) 468-5641
(802) 468-2923
Mailing address
71 ALLEN ST, SUITE 101, RUTLAND, VT 05701-4570
(800) 468-9118
(802) 772-7973
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
—
02940256
—
NY
05
—
1010851
—
VT
Enumeration date
05/19/2006
Last updated
06/21/2021
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