Healthcare Provider Details

I. General information

NPI: 1073636700
Provider Name (Legal Business Name): SPRINGFIELD HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL CT
BELLOWS FALLS VT
05101-1489
US

IV. Provider business mailing address

25 RIDGEWOOD RD PO BOX 2003
SPRINGFIELD VT
05156-3050
US

V. Phone/Fax

Practice location:
  • Phone: 802-463-1292
  • Fax:
Mailing address:
  • Phone: 802-885-2151
  • Fax: 802-885-7396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number694
License Number StateVT

VIII. Authorized Official

Name: MRS. MARY CUTTS
Title or Position: INSURANCE CREDENTIALING COORDINATOR
Credential:
Phone: 802-886-8953