MEDICARE: GIFFORD MEDICA CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	273Y00000X	Rehabilitation Hospital Unit	685	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659561942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIFFORD MEDICA CENTER

Provider Business Mailing Address
First Line	:	1823 VT RTE 107
Second Line	:
City	:	BETHEL
State	:	VT
Zip	:	05032-9107
Country	:	US
Telephone Number	:	802-728-2411
Fax Number	:

Provider Business Practice Location Address
First Line	:	1823 VT RTE 107
Second Line	:
City	:	BETHEL
State	:	VT
Zip	:	05032-9107
Country	:	US
Telephone Number	:	802-728-2411
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MICHAEL K COSTA
Credential	:
Telephone Number	:	802-728-2211

Provider Enumeration Date	:	08/01/2007
Last Update Date	:	07/01/2025

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Directions to “GIFFORD MEDICA CENTER ” Practice Location

Language	Start Address	Practice Location

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