Provider Demographics
NPI:1699755348
Name:NORTHEAST WASHINGTON COUNTY COMMUNITY HEALTH, INC.
Entity type:Organization
Organization Name:NORTHEAST WASHINGTON COUNTY COMMUNITY HEALTH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MACRITCHIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-454-8336
Mailing Address - Street 1:157 TOWNE AVE
Mailing Address - Street 2:P. O. BOX 320
Mailing Address - City:PLAINFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05667-9425
Mailing Address - Country:US
Mailing Address - Phone:802-454-8336
Mailing Address - Fax:802-454-8339
Practice Address - Street 1:157 TOWNE AVE.
Practice Address - Street 2:BOX 320
Practice Address - City:PLAINFIELD
Practice Address - State:VT
Practice Address - Zip Code:05667-0320
Practice Address - Country:US
Practice Address - Phone:802-454-8336
Practice Address - Fax:802-454-8339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTNOT ASSIGNED YETMedicaid
VTTHE0004516OtherOTHER PRIVATE INSURANCES
VT0473808Medicaid
VT1006333Medicaid
VT0007193Medicaid
VT1009448Medicaid
VTTHE 00004516OtherBLUE CROSS BLUE SHIELD
VTTHE00019920OtherBLUE CROSS BLUE SHIELD
VT0473808Medicaid
VTNOT ASSIGNED YETMedicare ID - Type UnspecifiedFQHC LOOK ALIKE
VTNOT ASSIGNED YETMedicaid