Provider Demographics
NPI:1164971495
Name:THE RICHFORD HEALTH CENTER INC
Entity Type:Organization
Organization Name:THE RICHFORD HEALTH CENTER INC
Other - Org Name:FAIRFAX HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENOIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-255-5562
Mailing Address - Street 1:44 MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RICHFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05476-1153
Mailing Address - Country:US
Mailing Address - Phone:802-255-5580
Mailing Address - Fax:
Practice Address - Street 1:1199 MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VT
Practice Address - Zip Code:05454-9530
Practice Address - Country:US
Practice Address - Phone:802-849-2844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE RICHFORD HEALTH CENTER INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-28
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)