Provider Demographics
NPI:1679558506
Name:TOWN OF COLCHESTER
Entity type:Organization
Organization Name:TOWN OF COLCHESTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TOWN MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:VOEGELE
Authorized Official - Suffix:
Authorized Official - Credentials:TOWN MANAGER
Authorized Official - Phone:802-654-0709
Mailing Address - Street 1:PO BOX 55
Mailing Address - Street 2:835 BLAKELY RD
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-0055
Mailing Address - Country:US
Mailing Address - Phone:802-655-3555
Mailing Address - Fax:802-654-0749
Practice Address - Street 1:687 BLAKELY RD
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446
Practice Address - Country:US
Practice Address - Phone:802-655-3555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTO3033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT38242OtherBLUE CROSS BLUE SHIELD
VTOAM0064Medicaid
VT38242OtherBLUE CROSS BLUE SHIELD