1861489437 NPI number — UPPER CONNECTICUT VALLEY HOSPITAL ASSOCIATION

Table of content: (NPI 1861489437)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861489437 NPI number — UPPER CONNECTICUT VALLEY HOSPITAL ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPPER CONNECTICUT VALLEY HOSPITAL ASSOCIATION
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:
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:
1861489437
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
181 CORLISS LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLEBROOK
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03576
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-237-4971
Provider Business Mailing Address Fax Number:
603-237-4452

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
181 CORLISS LANE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLEBROOK
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03576
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-237-4971
Provider Business Practice Location Address Fax Number:
603-237-4452
Provider Enumeration Date:
09/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
FRIZZELL
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
Authorized Official Title or Position:
CONTROLLER
Authorized Official Telephone Number:
603-237-4971

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X , with the licence number:  00592 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3078954 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0049127 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30 1300 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 59472 . This is a "VT BCBS EKG" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 138560000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 301300 . This is a "VT BCBS" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 49735 . This is a "VT BCBS ANESTHESIOLOGIST" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 926356 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00644 . This is a "VTW ED#" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 0301300 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5129902 . This is a "VMC" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 030 1300 . This is a "CAH" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 59471 . This is a "VT BCBS WALK IN CLINIC" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 301300 . This is a "VTW" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 39632 . This is a "VT BCBS ED#" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 49790 . This is a "VT BCBS SURGERY" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".




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