MEDICARE: MERTEN'S HOUSE

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	313M00000X	Nursing Facility/Intermediate Care Facility	47S002	VT

General Provider Information

NPI Number	:	1861488520
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERTEN'S HOUSE

Provider Business Mailing Address
First Line	:	73 RIVER ST
Second Line	:
City	:	WOODSTOCK
State	:	VT
Zip	:	05091-1226
Country	:	US
Telephone Number	:	802-457-4411
Fax Number	:	802-457-5722

Provider Business Practice Location Address
First Line	:	73 RIVER ST
Second Line	:
City	:	WOODSTOCK
State	:	VT
Zip	:	05091-1226
Country	:	US
Telephone Number	:	802-457-4411
Fax Number	:	802-457-5722

Authorized Official
Title or Position	:	ADM.
Name	:	CAROL WASHBURN
Credential	:
Telephone Number	:	802-457-4411

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	08/22/2020

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Directions to “MERTEN'S HOUSE ” Practice Location

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