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1422 Route 66 Uppr Level Randolph VT 05060-7718 | |
(802) 728-7100 | |
(802) 728-7199 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1422 Route 66 Uppr Level, Randolph, Vermont |
Authorized Official Name and Position | Daniel Bennett (CEO) |
Authorized Official Contact | 8027282211 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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44 S Main St Randolph VT 05060-1381 Ph: (802) 728-7000 | 1422 Route 66 Uppr Level Randolph VT 05060-7718 Ph: (802) 728-7100 |
NPI Number | 1619427663 |
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Provider Enumeration Date | 10/13/2016 |
Last Update Date | 08/03/2021 |
Medicare PECOS PAC ID | 2668624982 |
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Medicare Enrollment ID | O20170207002634 |
Identifier | Type | State | Issuer |
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1619427663 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Vermont) | Primary |
Gifford Health Care, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 44 South Main St., Randolph, VT 05060 Phone: 802-728-7000 Fax: 802-728-4245 | |