| Organization Name: | MAD RIVER FAMILY HEALTH |
| NPI Number: | 1902984974 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FRANCIS COOK (PHYSICIAN) |
| Mailing Address: | 859 Old County Rd Waitsfield |
| State: | VT US |
| Postal Code: | 056736093 |
| Phone Number: | 8024963838 |
| Fax Number: | 8024965586 |
| NPI Enumeration Date: | 11/01/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 042-0006636 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |