Provider Demographics
NPI:1508373655
Name:SPRINGFIELD MEDICAL CARE SYSTEMS INC
Entity Type:Organization
Organization Name:SPRINGFIELD MEDICAL CARE SYSTEMS INC
Other - Org Name:RIVERSIDE MIDDLE SCHOOL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTEMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-885-7344
Mailing Address - Street 1:25 RIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-3050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13 FAIRGROUND RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-2112
Practice Address - Country:US
Practice Address - Phone:802-885-8490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)