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195 Industrial Pkwy Ste 1 Lyndonville VT 05851-4511 | |
(802) 748-9501 | |
(802) 748-3420 |
Full Name | |
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Speciality | Clinic/Center |
Location | 195 Industrial Pkwy Ste 1, Lyndonville, Vermont |
Authorized Official Name and Position | Robert N Hersey (CFO) |
Authorized Official Contact | 8027487520 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 905 St Johnsbury VT 05819-0905 Ph: (802) 748-8141 | 195 Industrial Pkwy Ste 1 Lyndonville VT 05851-4511 Ph: (802) 748-9501 |
NPI Number | 1659459428 |
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Provider Enumeration Date | 11/01/2006 |
Last Update Date | 02/11/2020 |
Medicare PECOS PAC ID | 3678481405 |
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Medicare Enrollment ID | O20070104000291 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659459428 | NPI | - | NPPES |
0473988 | Medicaid | VT | |
1014190 | Medicaid | VT | |
3076795 | Medicaid | NH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 673 (Vermont) | Primary |
261QR1300X | Clinic/center - Rural Health | 673 (Vermont) | Secondary |
Post Acute Specialists Of Vermont Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 601 Red Village Rd, Lyndonville, VT 05851 Phone: 800-411-6768 | |