Healthcare Provider Details

I. General information

NPI: 1922029784
Provider Name (Legal Business Name): COPLEY HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 03/09/2022
Certification Date: 02/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

528 WASHINGTON HWY
MORRISVILLE VT
05661-8973
US

IV. Provider business mailing address

528 WASHINGTON HWY
MORRISVILLE VT
05661-8973
US

V. Phone/Fax

Practice location:
  • Phone: 802-888-8888
  • Fax:
Mailing address:
  • Phone: 802-888-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number667
License Number StateVT

VIII. Authorized Official

Name: JEFFREY HEBERT
Title or Position: CFO
Credential:
Phone: 802-888-8663