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Organization

NORTHERN COUNTIES HEALTH CARE, INC.

Active
Parent organization
NORTHERN COUNTIES HEALTH CARE, INC.
Other names
St. Johnsbury Community Health Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTHERN COUNTIES HEALTH CARE, INC.
Authorized official
PATRICK FLOOD (EXECUTIVE DIRECTOR/CEO)
(802) 748-9405
Entity
Organization

Contact information

Practice address
185 SHERMAN DRIVE, SUITE 1, ST JOHNSBURY, VT 05819
(802) 748-5401
(802) 748-5094
Mailing address
165 SHERMAN DR, ST JOHNSBURY, VT 05819-9811
(802) 748-9405
(802) 748-4540

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
261QH0100X
Health Service Clinic/Center
291U00000X
Clinical Medical Laboratory

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0471808
VT
01
471808
MEDICARE PROVIDER NUMBER
VT
Enumeration date
03/23/2007
Last updated
01/30/2014
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