Mad River Internal Medicine

LBN: Mad River Internal Medicine
Mad River Internal Medicine is an health care organization with primary practice located at 5360 Main St Ste. 2, Waitsfield VT 05673-6003. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Mad River Internal Medicine can be contacted via phone (802) 496-2202, or through Wargo, Timothy J via phone (802) 496-2202.

Contact Information

Primary practice address
5360 Main St Ste. 2 Waitsfield VT 05673-6003
Phone: (802) 496-2202
Fax: (802) 496-2223
Website:
Map and Directions
Authorized official contact:
Name: Wargo, Timothy J Doctor of Medicine (MD)
Phone: (802) 496-2202

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1730148966
LBN Legal business name Mad River Internal Medicine
DBA Doing business as
Authorized official Wargo, Timothy J Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 17th, 2006
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730148966 NPPES
Vermont MEDICAID 1012198

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