Provider Demographics
NPI:1265420913
Name:RICHFORD HEALTH CENTER, INC.
Entity type:Organization
Organization Name: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:STE 201
Mailing Address - City:RICHFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05476-1153
Mailing Address - Country:US
Mailing Address - Phone:802-255-5530
Mailing Address - Fax:802-255-5539
Practice Address - Street 1:44 MAIN ST
Practice Address - Street 2:STE 201
Practice Address - City:RICHFORD
Practice Address - State:VT
Practice Address - Zip Code:05476-1153
Practice Address - Country:US
Practice Address - Phone:802-255-5530
Practice Address - Fax:802-255-5539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-07
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT3347183500000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT4702569OtherNATIONAL COUNSEL ON PRESC
VT1012328Medicaid
VT1011139Medicaid
VT5311300001Medicare NSC