Provider Demographics
NPI:1487915351
Name:PINEWOOD TMS
Entity type:Organization
Organization Name:PINEWOOD TMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:802-246-1304
Mailing Address - Street 1:167 MAIN ST
Mailing Address - Street 2:OFFICE 310
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-7128
Mailing Address - Country:US
Mailing Address - Phone:802-246-1304
Mailing Address - Fax:802-246-1314
Practice Address - Street 1:167 MAIN ST
Practice Address - Street 2:OFFICE 310
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-7128
Practice Address - Country:US
Practice Address - Phone:802-246-1304
Practice Address - Fax:802-246-1314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0028740163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT026.0028740OtherNURSING LICENSE