Healthcare Provider Details

I. General information

NPI: 1780770511
Provider Name (Legal Business Name): PORTER HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 PORTER DRIVE PORTER HOSPITAL
MIDDLEBURY VT
05753
US

IV. Provider business mailing address

115 PORTER DRIVE CO SUSAN SPITZNER FINANCE DEPT
MIDDLEBURY VT
05753
US

V. Phone/Fax

Practice location:
  • Phone: 802-388-5607
  • Fax: 802-388-5654
Mailing address:
  • Phone: 802-388-5607
  • Fax: 802-388-5654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number675
License Number StateVT

VIII. Authorized Official

Name: STEVEN T CIAMPA
Title or Position: CFO
Credential:
Phone: 802-388-4752