CHAMPLAIN VALLEY URGENT CARE PC NPI 1902990674

NPI Information

NPI: 1902990674
Provider Name: CHAMPLAIN VALLEY URGENT CARE, PC
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

CLIA Number: 47D1100531

Address:
7 FAYETTE DR
SOUTH BURLINGTON, VT
ZIP 05403
Phone: (802) 865-3655
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CHAMPLAIN VALLEY URGENT CARE, PC is an urgent care clinic center in South Burlington, VT. CHAMPLAIN VALLEY URGENT CARE, PC NPI is 1902990674. The provider is registered as an organization entity type.

The provider's business location address is:

7 FAYETTE DR
SOUTH BURLINGTON, VT
ZIP 05403-977
Phone: (802) 865-3655
Fax: (802) 865-3626

The provider's authorized official is Timothy Fitzgerald .
The authorized official title is Ceo and has the following contact phone number (802) 865-3655.

The CLIA number assigned to this NPI record is 47D1100531 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/3/2006 and was last updated on 8/22/2020.

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			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	58634	OTHER	VERMONT	BCBS OF VT GROUP NUMBER

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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