Organization
GIFFORD MEDICAL CENTER
Active
Parent organization
MENIG EXTENDED CARE FACILITY
Organization subpart
Yes
Provider details
NPI number
Legal business name
MENIG EXTENDED CARE FACILITY
Authorized official
BROOKS CHAPIN RN (DIRECTOR OF NURSING)
(802) 728-2123
Entity
Organization
Contact information
Practice address
44 S MAIN ST, RANDOLPH, VT 05060-1381
(802) 728-2125
(802) 728-2143
Mailing address
44 S MAIN ST, RANDOLPH, VT 05060-1381
(802) 728-2123
(802) 728-2143
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
0270000358
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
475058
—
VT
Enumeration date
06/27/2011
Last updated
09/17/2014
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