Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 1199 Main St, Fairfax, Vermont |
Authorized Official Name and Position | Kathy Benoit (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8022555562 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
44 Main St Suite 200 Richford VT 05476-1153 Ph: (802) 255-5580 | 1199 Main St Fairfax VT 05454-9530 Ph: (802) 849-2844 |
NPI Number | 1164971495 |
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Provider Enumeration Date | 09/28/2016 |
Last Update Date | 08/29/2023 |
Medicare PECOS PAC ID | 7012825631 |
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Medicare Enrollment ID | O20170725001531 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164971495 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Fairfax Associates In Medicine Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1199 Main St, Fairfax, VT 05454 Phone: 802-849-2844 Fax: 802-849-2644 |