Provider Demographics
NPI:1003248238
Name:CHAMPLAIN VALLEY HEMATOLOGY ONCOLOGY, PC
Entity Type:Organization
Organization Name:CHAMPLAIN VALLEY HEMATOLOGY ONCOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-655-7173
Mailing Address - Street 1:792 COLLEGE PKWY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-3052
Mailing Address - Country:US
Mailing Address - Phone:802-655-3400
Mailing Address - Fax:802-655-9170
Practice Address - Street 1:792 COLLEGE PKWY
Practice Address - Street 2:SUITE 207
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-3052
Practice Address - Country:US
Practice Address - Phone:802-655-3400
Practice Address - Fax:802-655-9170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty