Provider Demographics
NPI:1992353445
Name:VILLAGE HEALTH, INC.
Entity type:Organization
Organization Name:VILLAGE HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN, SECRETARY/TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:ROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-922-6538
Mailing Address - Street 1:5 PARK ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-1169
Mailing Address - Country:US
Mailing Address - Phone:802-922-6538
Mailing Address - Fax:
Practice Address - Street 1:5 PARK ST STE 3A
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1169
Practice Address - Country:US
Practice Address - Phone:802-922-6538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty