Provider Demographics
NPI:1922763952
Name:GARNET CLINICAL SERVICES LLC
Entity Type:Organization
Organization Name:GARNET CLINICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-876-2301
Mailing Address - Street 1:34 BLAIR PARK RD STE 104
Mailing Address - Street 2:BOX 327
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-7991
Mailing Address - Country:US
Mailing Address - Phone:802-876-2300
Mailing Address - Fax:
Practice Address - Street 1:1000 RIVER ST BLDG 900
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-4201
Practice Address - Country:US
Practice Address - Phone:802-876-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care