1497885107 NPI number — NFI VERMONT, INC

Table of content: (NPI 1497885107)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497885107 NPI number — NFI VERMONT, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NFI VERMONT, 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:
Provider Other Organization Name Type Code:
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:
1497885107
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30 AIRPORT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH BURLINGTON
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05403-6432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-658-0040
Provider Business Mailing Address Fax Number:
802-658-0216

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 AIRPORT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH BURLINGTON
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05403-6432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-658-0040
Provider Business Practice Location Address Fax Number:
802-658-0216
Provider Enumeration Date:
03/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MYERS
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
R
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
802-658-0040

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 320800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 323P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 1004136 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007658 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00068960 . This is a "BC-BS PROVIDER ID#" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 00068969 . This is a "BC-BS PROVIDER ID#" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 1011116 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1004944 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 960839 . This is a "MVP PROVIDER ID#" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 6030011 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".




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