Provider Demographics
NPI:1508342114
Name:ACTD,LLC
Entity Type:Organization
Organization Name:ACTD,LLC
Other - Org Name:GREEN MOUNTAIN SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-488-5350
Mailing Address - Street 1:593 HERCULES DR
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-5993
Mailing Address - Country:US
Mailing Address - Phone:802-488-5350
Mailing Address - Fax:802-338-9390
Practice Address - Street 1:593 HERCULES DR
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-0544
Practice Address - Country:US
Practice Address - Phone:802-488-5350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical