HOPE MEDICAL CLINIC PLLC NPI 1306116801

NPI Information

NPI: 1306116801
Provider Name: HOPE MEDICAL CLINIC PLLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 47D2040632

Address:
92 ALLEN ST
RUTLAND, VT
ZIP 05701
Phone: (802) 773-7502
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HOPE MEDICAL CLINIC PLLC is a primary care clinic center in Rutland, VT. HOPE MEDICAL CLINIC PLLC NPI is 1306116801. The provider is registered as an organization entity type.

The provider's business location address is:

92 ALLEN ST
RUTLAND, VT
ZIP 05701-562
Phone: (802) 773-7502
Fax: (802) 773-7022

The provider's authorized official is Susan F Dumas .
The authorized official title is Owner and has the following contact phone number (802) 773-7502.

The CLIA number assigned to this NPI record is 47D2040632 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/31/2011 and was last updated on 4/17/2017.

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	261QP2300X	Clinic/Center	Primary Care	1010015655	VERMONT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	47D2040632	OTHER		CLIA WAIVER
2	1008529	MEDICAID	VERMONT
3	0025803	OTHER	VERMONT	MEDICARE PTAN
4	1020249	OTHER	VERMONT	MEDICAID FOR HOPE MEDICAL CLINIC
5	5501740	OTHER	VERMONT	MVP

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: 5/5/2024

NPI Synchronization or Removal

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