Provider Demographics
NPI:1083904114
Name:VERMONT OPEN MRI
Entity Type:Organization
Organization Name:VERMONT OPEN MRI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:C
Authorized Official - Last Name:KUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-338-5476
Mailing Address - Street 1:3000 WILLISTON RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6082
Mailing Address - Country:US
Mailing Address - Phone:802-863-1249
Mailing Address - Fax:802-863-9979
Practice Address - Street 1:3000 WILLISTON RD
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6082
Practice Address - Country:US
Practice Address - Phone:802-863-1249
Practice Address - Fax:802-863-9979
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MINGLEWOOD MEDICAL IMAGING MANAGEMENT COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-11
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)