MEDICARE: TOWN OF SHELBURNE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	0323	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2534	OTHER	VT	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053394973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWN OF SHELBURNE

Provider Business Mailing Address
First Line	:	PO BOX 254
Second Line	:
City	:	SHELBURNE
State	:	VT
Zip	:	05482-0254
Country	:	US
Telephone Number	:	802-985-5125
Fax Number	:	802-985-5128

Provider Business Practice Location Address
First Line	:	154 TURTLE LANE
Second Line	:
City	:	SHELBURNE
State	:	VT
Zip	:	05482
Country	:	US
Telephone Number	:	802-985-5125
Fax Number	:	802-985-5128

Authorized Official
Title or Position	:	TREASURER
Name	:	WENDI TURNER
Credential	:
Telephone Number	:	802-985-5125

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	04/26/2011

Similar Medicare Providers

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Practice Location Address:

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1063400190 — KAREN CLEARY M.D.
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1477535219 — DR. LINDA VIETH ROSENBLAD PH.D.
Practice Location Address:

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1548244593 — TIMOTHY C GOULD DPT
Practice Location Address:

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1336123918 — EVELYN M SMITH MA LCMHC
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1215902150 — MS. JESSICA A YOUNG LICSW
Practice Location Address:

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Directions to “TOWN OF SHELBURNE ” Practice Location

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