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General NPI Number Information
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NPI Number | 1689473399
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 62 WOODSTOCK AVE
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City | RUTLAND
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State | VT
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Zip | 05701-3534
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Country | US
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Telephone | 802-775-4321
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Fax |
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Provider Business Mailing Address
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Address Line | 420 GROVE ST STE 2
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City | BRANDON
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State | VT
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Zip | 05733-9062
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Country | US
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Telephone | 802-465-0011
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. RYAN WALTZER
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Credential | PHARMD
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Telephone | 508-272-1390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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