Healthcare Provider Details
I. General information
NPI: 1346859089
Provider Name (Legal Business Name): GARNET TRANSPORT MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/29/2020
Last Update Date: 04/18/2022
Certification Date: 04/18/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 RIVER ST BLDG 900
ESSEX JUNCTION VT
05452-4201
US
IV. Provider business mailing address
34 BLAIR PARK RD STE 104
WILLISTON VT
05495-7991
US
V. Phone/Fax
- Phone: 802-876-2300
- Fax: 802-876-2398
- Phone: 802-876-2300
- Fax: 802-876-2398
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RYAN
T
FERRIS
Title or Position: PRESIDENT & CEO
Credential:
Phone: 802-876-2301