Healthcare Provider Details

I. General information

NPI: 1528026457
Provider Name (Legal Business Name): MANCHESTER HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 05/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5468 MAIN STREET
MANCHESTER CENTER VT
05255-1224
US

IV. Provider business mailing address

PO BOX 1224
MANCHESTER CENTER VT
05255-1224
US

V. Phone/Fax

Practice location:
  • Phone: 802-362-2126
  • Fax: 802-362-4884
Mailing address:
  • Phone: 802-362-2126
  • Fax: 802-362-4884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: BARBARA L KEOUGH
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 802-362-2126