MEDICARE: NORTH COUNTRY HOSPITAL & HEALTH CENTER 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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	207X00000X	Orthopaedic Surgery Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CA2318	OTHER	VT	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	NORT00058350	OTHER	VT	BLUE SHIELD

General Provider Information

NPI Number	:	1578592606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH COUNTRY HOSPITAL & HEALTH CENTER INC

Provider Business Mailing Address
First Line	:	81 MEDICAL VILLAGE DR
Second Line	:	SUITE 4
City	:	NEWPORT
State	:	VT
Zip	:	05855-9835
Country	:	US
Telephone Number	:	802-334-4175
Fax Number	:	802-334-4176

Provider Business Practice Location Address
First Line	:	81 MEDICAL VILLAGE DR STE 1
Second Line	:
City	:	NEWPORT
State	:	VT
Zip	:	05855-9897
Country	:	US
Telephone Number	:	802-334-4175
Fax Number	:	802-334-4176

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

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	09/12/2023

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Directions to “NORTH COUNTRY HOSPITAL & HEALTH CENTER INC ” Practice Location

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