Organization
FIVE-TOWN HEALTH ALLIANCE, INC
Active
Parent organization
FIVE-TOWN HEALTH ALLIANCE, INC
Other names
Mountain Health Ctr.
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIVE-TOWN HEALTH ALLIANCE, INC
Authorized official
MARTHA A HALNON (CHIEF EXECUTIVE OFFICER)
(802) 453-5116
Entity
Organization
Contact information
Practice address
56 COLLEGE ST, MIDDLEBURY, VT 05753-1447
(802) 453-5028
Mailing address
74 MUNSILL AVE STE 100, BRISTOL, VT 05443-1047
(802) 453-5028
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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