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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
1261QR1300XRural Health Clinic/Center673VT
2261QP2300XPrimary Care Clinic/Center673VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659459428
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 :
Provider Business Practice Location Address
First Line : 195 INDUSTRIAL PKWY STE 1
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 : 11/01/2006
Last Update Date : 02/11/2020

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Directions to “NORTHEASTERN VERMONT REGIONAL HOSPITAL INC. ” Practice Location

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