| Chcb | |
|
617 Riverside Ave Burlington VT 05401-1601 | |
| (802) 864-6309 | |
| (802) 860-4325 |
| Full Name | Chcb |
|---|---|
| Speciality | Clinic/Center |
| Location | 617 Riverside Ave, Burlington, Vermont |
| Authorized Official Name and Position | David Simmons (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8028646309 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chcb 617 Riverside Ave Burlington VT 05401-1601 Ph: (802) 864-6309 | Chcb 617 Riverside Ave Burlington VT 05401-1601 Ph: (802) 864-6309 |
| NPI Number | 1083832851 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 07/13/2022 |
| Medicare PECOS PAC ID | 2062491251 |
|---|---|
| Medicare Enrollment ID | O20101012001201 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083832851 | NPI | - | NPPES |
| 0000F02 | Medicaid | VT | |
| VT4600 | Other | VT | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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