Provider Demographics
NPI:1033530696
Name:BATTENKILL VALLEY HEALTH CENTER, INC
Entity Type:Organization
Organization Name:BATTENKILL VALLEY HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PRACTICE ADMINISTRATION
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-430-7254
Mailing Address - Street 1:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05250
Mailing Address - Country:US
Mailing Address - Phone:802-375-6566
Mailing Address - Fax:802-375-6828
Practice Address - Street 1:9 CHURCH ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05250
Practice Address - Country:US
Practice Address - Phone:802-375-6566
Practice Address - Fax:802-375-6828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-30
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No291U00000XLaboratoriesClinical Medical Laboratory