Provider Demographics
NPI:1487909974
Name:VOCATIONAL REHABILIATION VERMONT
Entity type:Organization
Organization Name:VOCATIONAL REHABILIATION VERMONT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, VT AT PROGRAM
Authorized Official - Prefix:MS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:FULCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-279-3150
Mailing Address - Street 1:103 S MAIN ST WEEKS BLDG
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05671-0001
Mailing Address - Country:US
Mailing Address - Phone:802-279-3150
Mailing Address - Fax:
Practice Address - Street 1:103 S MAIN ST WEEKS BLDG
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:VT
Practice Address - Zip Code:05671-0001
Practice Address - Country:US
Practice Address - Phone:802-279-3150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment