Healthcare Provider Details

I. General information

NPI: 1457746661
Provider Name (Legal Business Name): NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2015
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 MEDICAL VILLAGE DR
NEWPORT VT
05855-9834
US

IV. Provider business mailing address

121 MEDICAL VILLAGE DR
NEWPORT VT
05855-9834
US

V. Phone/Fax

Practice location:
  • Phone: 802-334-4111
  • Fax: 802-334-3281
Mailing address:
  • Phone: 802-334-5929
  • Fax: 802-487-1051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number832
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number832
License Number StateVT

VIII. Authorized Official

Name: DEBORAH L BROWN
Title or Position: ENROLLMENT SPECILIST
Credential:
Phone: 802-334-3210