Healthcare Provider Details

I. General information

NPI: 1346683562
Provider Name (Legal Business Name): MH HEALTH CARE SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 INNOVATION DR C/O VCS HEALTH CENTER
NORTH CLARENDON VT
05759-9230
US

IV. Provider business mailing address

20 WINOOSKI FALLS WAY STE 400
WINOOSKI VT
05404-2239
US

V. Phone/Fax

Practice location:
  • Phone: 802-776-3670
  • Fax:
Mailing address:
  • Phone: 802-857-0400
  • Fax: 802-857-0498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. TERRY LAYMAN
Title or Position: CORPORATE MEDICAL OFFICER
Credential: MD
Phone: 317-727-6898