1639127681 NPI number — LAMOILLE HEALTH PARTNERS, INC

Table of content: (NPI 1639127681)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639127681 NPI number — LAMOILLE HEALTH PARTNERS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAMOILLE HEALTH PARTNERS, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LAMOILLE HEALTH FAMILY MEDICINE MORRISVILLE
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639127681
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 749
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRISVILLE
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05661-0749
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-851-8600
Provider Business Mailing Address Fax Number:
802-851-8313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
609 WASHINGTON HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORRISVILLE
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05661-8652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-888-5639
Provider Business Practice Location Address Fax Number:
802-888-6040
Provider Enumeration Date:
05/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MAY
Authorized Official First Name:
STUART
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/PRESIDENT
Authorized Official Telephone Number:
802-888-0901

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0VN1557 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: COPL00029507 . This is a "BCBS" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: C12317 . This is a "RR MEDICARE" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".




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