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NPI Code Detail

MEDICARE: NORTHEASTERN VERMONT REGIONAL HOSPITAL, INC.

MEDICARE: NORTHEASTERN VERMONT REGIONAL HOSPITAL, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282NC0060XCritical Access Hospital

General Provider Information

NPI Number : 1518509017
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHEASTERN VERMONT REGIONAL HOSPITAL, INC.
Provider Business Mailing Address
First Line : PO BOX 905
Second Line :
City : ST JOHNSBURY
State : VT
Zip : 05819-0905
Country : US
Telephone Number : 802-748-8141
Fax Number : 802-748-4098
Provider Business Practice Location Address
First Line : 195 INDUSTRIAL PKWY
Second Line :
City : LYNDONVILLE
State : VT
Zip : 05851-4511
Country : US
Telephone Number : 802-748-9501
Fax Number : 802-748-3420
Authorized Official
Title or Position : CFO
Name : ROBERT N HERSEY
Credential :
Telephone Number : 802-748-7520
Provider Enumeration Date : 10/16/2019
Last Update Date : 10/16/2019

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