Organization Active NPI

Cold Hollow Family Practice

  • Clinic Pharmacy
  • Enosburg Falls, VT
National Provider Identifier
1902064496
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
COLD HOLLOW FAMILY PRACTICE
Practice address
84 Water Tower Rd
Suite 1
Enosburg Falls, VT 05450-6097
Phone
(802) 933-6664
Fax
(802) 933-8333
NPI assigned
May 30, 2008
Last updated
May 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Candace M Collins
Title
Clinic Administrator
Phone
(802) 933-6664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X NU Primary

Addresses

Primary practice location

84 Water Tower Rd
Suite 1
Enosburg Falls, VT 05450-6097

Mailing address

84 Water Tower Rd
Suite 1
Enosburg Falls, VT 05450-6097
Phone (802) 933-6664

Other identifiers 1

IdentifierTypeStateIssuer
1014837MedicaidVT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212105600000",
    "number": "1902064496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 WATER TOWER RD",
            "address_2": "SUITE 1",
            "city": "ENOSBURG FALLS",
            "state": "VT",
            "postal_code": "054506097",
            "telephone_number": "802-933-6664",
            "fax_number": "802-933-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 WATER TOWER RD",
            "address_2": "SUITE 1",
            "city": "ENOSBURG FALLS",
            "state": "VT",
            "postal_code": "054506097",
            "telephone_number": "802-933-6664",
            "fax_number": "802-933-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLD HOLLOW FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "802-933-6664"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014837",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enosburg Falls, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.