| Common Street Health Center | |
|
4 Commons St Rutland VT 05701-4651 | |
| (802) 773-1321 | |
| Not Available |
| Full Name | Common Street Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 4 Commons St, Rutland, Vermont |
| Authorized Official Name and Position | Grant L Whitmer (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8024685641 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Common Street Health Center 4 Commons St Rutland VT 05701-4651 Ph: (802) 773-1321 | Common Street Health Center 4 Commons St Rutland VT 05701-4651 Ph: (802) 773-1321 |
| NPI Number | 1063715886 |
|---|---|
| Provider Enumeration Date | 12/16/2010 |
| Last Update Date | 08/10/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063715886 | NPI | - | NPPES |
| 0471838 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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