| Northwestern Medical Center, Inc. | |
|
4178 Highbridge Rd Fairfax VT 05454-5446 | |
| (802) 752-1930 | |
| (802) 524-2867 |
| Full Name | Northwestern Medical Center, Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 4178 Highbridge Rd, Fairfax, Vermont |
| Authorized Official Name and Position | Mary E Pigeon (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 8025248954 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwestern Medical Center, Inc. 133 Fairfield St Saint Albans VT 05478-1726 Ph: (802) 524-5911 | Northwestern Medical Center, Inc. 4178 Highbridge Rd Fairfax VT 05454-5446 Ph: (802) 752-1930 |
| NPI Number | 1417287665 |
|---|---|
| Provider Enumeration Date | 01/12/2010 |
| Last Update Date | 10/26/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417287665 | NPI | - | NPPES |
| 1017250 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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