Provider Demographics
NPI:1164201562
Name:OM FISHER HOME
Entity Type:Organization
Organization Name:OM FISHER HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:PALOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-223-1068
Mailing Address - Street 1:171 WESTVIEW MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-3385
Mailing Address - Country:US
Mailing Address - Phone:802-223-1068
Mailing Address - Fax:
Practice Address - Street 1:171 WESTVIEW MEADOWS RD
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-3385
Practice Address - Country:US
Practice Address - Phone:802-223-1068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care