Healthcare Provider Details

I. General information

NPI: 1265578777
Provider Name (Legal Business Name): PORTER HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 02/17/2024
Certification Date: 02/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 PORTER DRIVE
MIDDLEBURY VT
05753
US

IV. Provider business mailing address

115 PORTER DRIVE C O SUSAN SPITZNER
MIDDLEBURY VT
05753
US

V. Phone/Fax

Practice location:
  • Phone: 802-388-4701
  • 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 Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number691
License Number StateVT

VIII. Authorized Official

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