Provider Demographics
NPI:1184611378
Name:THE RICHFORD HEALTH CENTER INC
Entity type:Organization
Organization Name:THE RICHFORD HEALTH CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENOIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-255-5562
Mailing Address - Street 1:44 MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RICHFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05476-1141
Mailing Address - Country:US
Mailing Address - Phone:802-255-5580
Mailing Address - Fax:802-255-5589
Practice Address - Street 1:382 MAIN ST
Practice Address - Street 2:
Practice Address - City:ENOSBURG FALLS
Practice Address - State:VT
Practice Address - Zip Code:05450-6008
Practice Address - Country:US
Practice Address - Phone:802-933-5831
Practice Address - Fax:802-933-5836
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE RICHFORD HEALTH CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-03
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT19697OtherBCBS
VT0471812Medicaid
VT0000F04Medicaid
VT0471812Medicaid
VTCK1568Medicare PIN