Healthcare Provider Details

I. General information

NPI: 1679551238
Provider Name (Legal Business Name): NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 MEDICAL VILLAGE DRIVE
NEWPORT VT
05855-9326
US

IV. Provider business mailing address

189 PROUTY DR
NEWPORT VT
05855-9326
US

V. Phone/Fax

Practice location:
  • Phone: 802-334-3500
  • Fax: 802-334-3502
Mailing address:
  • Phone: 802-334-3500
  • Fax: 802-334-3502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

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