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General NPI Number Information
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NPI Number | 1831113331
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Entity Type | Organization
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Legal Business Name | SOUTHWESTERN VERMONT HEALTH CARE
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 01/11/2008
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Provider Practice Location Address
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Address Line | 100 HOSPITAL DR
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City | BENNINGTON
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State | VT
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Zip | 05201-5004
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Country | US
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Telephone | 802-442-6361
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Fax | 802-447-4537
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Provider Business Mailing Address
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Address Line | 100 HOSPITAL DR
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City | BENNINGTON
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State | VT
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Zip | 05201-5004
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Country | US
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Telephone | 802-442-6361
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Fax | 802-447-4537
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Authorized Official
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Title or Position | DIRECTOR
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Name | MISS MARY WICKER
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Credential |
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Telephone | 802-442-6361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number |
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License Number State |
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