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General NPI Number Information
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NPI Number | 1457781031
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Entity Type | Organization
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Legal Business Name | GIFFORD HEALTH CARE, INC
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Dates
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Enumeration Date | 11/19/2013
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 356 VT RTE110
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City | CHELSEA
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State | VT
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Zip | 05038-8993
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Country | US
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Telephone | 802-685-4400
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Fax | 802-685-4329
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Provider Business Mailing Address
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Address Line | 44 S MAIN ST
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City | RANDOLPH
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State | VT
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Zip | 05060-1381
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Country | US
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Telephone | 802-728-7000
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Fax | 802-728-4245
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL K COSTA
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Credential |
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Telephone | 802-728-2211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | VT
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