1295868008 NPI number — NORTH COUNTRY HOSPITAL & HEALTH CENTER INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295868008 NPI number — NORTH COUNTRY HOSPITAL & HEALTH CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295868008
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
81 MEDICAL VILLAGE DR
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
NEWPORT
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05855-9836
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-334-4110
Provider Business Mailing Address Fax Number:
802-334-4113

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
81 MEDICAL VILLAGE DR STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWPORT
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05855-9897
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-334-4110
Provider Business Practice Location Address Fax Number:
802-334-3281
Provider Enumeration Date:
03/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
L
Authorized Official Title or Position:
ENROLLMENT SPECIALIST
Authorized Official Telephone Number:
802-334-3210

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0473982 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: OVN0584 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015608544 . This is a "HARVARD PILGRAM HEALTH PL" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 8000747 . This is a "LADIES FIRST DEPT OF HEAL" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: NORT00029083 . This is a "BLUE SHIELD OF VERMONT" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 101315300 . This is a "DEPT OF LABOR WORKERS COM" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 30008005 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: CG5262 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".




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