Provider Demographics
NPI:1356437248
Name:MONARCH MEDICAL LLC
Entity type:Organization
Organization Name:MONARCH MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:PELTIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-527-0077
Mailing Address - Street 1:PO BOX 1159
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-1159
Mailing Address - Country:US
Mailing Address - Phone:802-527-0077
Mailing Address - Fax:802-527-0073
Practice Address - Street 1:12 FAIRFIELD HILL RD
Practice Address - Street 2:SUITE #2
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-9634
Practice Address - Country:US
Practice Address - Phone:802-527-0077
Practice Address - Fax:802-527-0073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTMONA 00059400OtherBC BS PROVIDER NUMBER
VT1008684Medicaid
VT6788001OtherVMC PROVIDER NUMBER
VT6788001OtherVMC PROVIDER NUMBER
VT1008684Medicaid