| Shorewell Community Health Center | |
|
2987 Vt Route 22a Shoreham VT 05770-9728 | |
| (802) 897-7000 | |
| (802) 897-7718 |
| Full Name | Shorewell Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2987 Vt Route 22a, Shoreham, Vermont |
| Authorized Official Name and Position | Michael Gardner (FINANCE DIRECTOR) |
| Authorized Official Contact | 8028852083 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shorewell Community Health Center 71 Allen St Suite 101 Rutland VT 05701-4570 Ph: (800) 468-9118 | Shorewell Community Health Center 2987 Vt Route 22a Shoreham VT 05770-9728 Ph: (802) 897-7000 |
| NPI Number | 1811241094 |
|---|---|
| Provider Enumeration Date | 11/09/2012 |
| Last Update Date | 01/18/2017 |
| Medicare PECOS PAC ID | 2961467386 |
|---|---|
| Medicare Enrollment ID | O20121214000153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811241094 | NPI | - | NPPES |
| 1021223 | Medicaid | VT | |
| 0471844 | Medicaid | VT | |
| 03891792 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |