Provider Demographics
NPI:1275059644
Name:SOUTHWESTERN VERMONT MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:SOUTHWESTERN VERMONT MEDICAL CENTER, INC
Other - Org Name:SVMC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DREW
Authorized Official - Middle Name:
Authorized Official - Last Name:LERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-447-4587
Mailing Address - Street 1:100 HOSPITAL DRIVE
Mailing Address - Street 2:BOX 44
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201
Mailing Address - Country:US
Mailing Address - Phone:802-447-4587
Mailing Address - Fax:
Practice Address - Street 1:140 HOSPITAL DR STE 104
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-5010
Practice Address - Country:US
Practice Address - Phone:802-442-6361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty