Provider Demographics
NPI:1053525139
Name:NORTHEAST WASHINGTON COUNTY COMMUNITY HEALTH INC
Entity type:Organization
Organization Name:NORTHEAST WASHINGTON COUNTY COMMUNITY HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MACRITCHIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-454-8336
Mailing Address - Street 1:P O BOX 320
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05667-0320
Mailing Address - Country:US
Mailing Address - Phone:802-454-8336
Mailing Address - Fax:802-454-8339
Practice Address - Street 1:157 TOWNE AVE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:VT
Practice Address - Zip Code:05667-0320
Practice Address - Country:US
Practice Address - Phone:802-454-8336
Practice Address - Fax:802-454-8339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0471818Medicaid