Provider Demographics
NPI:1487602868
Name:GOODHEALTH P.C.
Entity type:Organization
Organization Name:GOODHEALTH P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:PITCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-860-1441
Mailing Address - Street 1:368 DORSET ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6212
Mailing Address - Country:US
Mailing Address - Phone:802-860-1441
Mailing Address - Fax:
Practice Address - Street 1:368 DORSET ST
Practice Address - Street 2:SUITE 1
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6212
Practice Address - Country:US
Practice Address - Phone:802-860-1441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT47D1068228291U00000X
261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN2426Medicaid
VTCB4933OtherRAIL ROAD MEDICARE
VTVN2426Medicare PIN