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82 Maple Street Island Pond VT 05846 | |
(802) 723-4300 | |
(802) 723-4544 |
Full Name | |
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Speciality | Clinic/Center |
Location | 82 Maple Street, Island Pond, Vermont |
Authorized Official Name and Position | Patrick Flood (EXECUTIVE DIRECTOR/CEO) |
Authorized Official Contact | 8027489405 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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165 Sherman Drive St Johnsbury VT 05819 Ph: (802) 748-9405 | 82 Maple Street Island Pond VT 05846 Ph: (802) 723-4300 |
NPI Number | 1992822555 |
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Provider Enumeration Date | 03/26/2007 |
Last Update Date | 01/30/2014 |
Medicare PECOS PAC ID | 2860300936 |
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Medicare Enrollment ID | O20100825000939 |
Identifier | Type | State | Issuer |
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1992822555 | NPI | - | NPPES |
0473811 | Medicaid | VT | |
471804 | Other | VT | MEDICARE PROVIDER NUMBER |