Healthcare Provider Details

I. General information

NPI: 1699755348
Provider Name (Legal Business Name): NORTHEAST WASHINGTON COUNTY COMMUNITY HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 TOWNE AVE. BOX 320
PLAINFIELD VT
05667-0320
US

IV. Provider business mailing address

157 TOWNE AVE P. O. BOX 320
PLAINFIELD VT
05667-9425
US

V. Phone/Fax

Practice location:
  • Phone: 802-454-8336
  • Fax: 802-454-8339
Mailing address:
  • Phone: 802-454-8336
  • Fax: 802-454-8339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH MACRITCHIE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 802-454-8336