Provider Demographics
NPI:1437618022
Name:RUTLAND FAMILY CARE, LLC
Entity Type:Organization
Organization Name:RUTLAND FAMILY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SHEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:802-235-3680
Mailing Address - Street 1:33 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN SPRINGS
Mailing Address - State:VT
Mailing Address - Zip Code:05757-4446
Mailing Address - Country:US
Mailing Address - Phone:802-235-3680
Mailing Address - Fax:
Practice Address - Street 1:25 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-6100
Practice Address - Country:US
Practice Address - Phone:802-282-3006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care