KILLINGTON MEDICAL CLINIC LLC NPI 1134467038

NPI Information

NPI: 1134467038
Provider Name: KILLINGTON MEDICAL CLINIC LLC
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

CLIA Number: 47D2071630

Address:
3902 KILLINGTON RD
KILLINGTON, VT
ZIP 05751
Phone: (802) 422-6125
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KILLINGTON MEDICAL CLINIC LLC is an urgent care clinic center in Killington, VT. KILLINGTON MEDICAL CLINIC LLC NPI is 1134467038. The provider is registered as an organization entity type.

The provider's business location address is:

3902 KILLINGTON RD
KILLINGTON, VT
ZIP 05751-822
Phone: (802) 422-6125
Fax: (802) 422-6798

The provider's authorized official is Edward Ogorzalek .
The authorized official title is Vp, Chief Financial Officer and has the following contact phone number (802) 747-1630.

The CLIA number assigned to this NPI record is 47D2071630 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/28/2013 and was last updated on 1/28/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QU0200X	Clinic/Center	Urgent Care	L0038157	VERMONT	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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