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General NPI Number Information
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NPI Number | 1679552723
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF VERMONT AND STATE AGRICULTURAL COLLEGE
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Dates
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Enumeration Date | 01/16/2006
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Last Update Date | 01/28/2011
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Provider Practice Location Address
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Address Line | 284 EAST AVE STE 1
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City | BURLINGTON
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State | VT
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Zip | 05405-3401
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Country | US
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Telephone | 802-656-4287
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Fax | 802-656-9350
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Provider Business Mailing Address
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Address Line | 425 PEARL STREET
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City | BURLINGTON
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State | VT
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Zip | 05401-3308
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Country | US
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Telephone | 802-656-8509
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Fax | 802-656-9350
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Authorized Official
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Title or Position | BILLING AGENT
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Name | DONNA DECKER
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Credential |
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Telephone | 802-656-8509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 0314
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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