Provider Demographics
NPI:1366690190
Name:AMBULATORY ANESTHESIA OF VERMONT, PLC
Entity Type:Organization
Organization Name:AMBULATORY ANESTHESIA OF VERMONT, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:POMICTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-985-1488
Mailing Address - Street 1:5224 SHELBURNE RD
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE
Mailing Address - State:VT
Mailing Address - Zip Code:05482-6621
Mailing Address - Country:US
Mailing Address - Phone:802-985-1488
Mailing Address - Fax:
Practice Address - Street 1:1100 HINESBURG RD
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7613
Practice Address - Country:US
Practice Address - Phone:802-985-1488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty