Healthcare Provider Details

I. General information

NPI: 1295868008
Provider Name (Legal Business Name): NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 MEDICAL VILLAGE DR STE 2
NEWPORT VT
05855-9897
US

IV. Provider business mailing address

81 MEDICAL VILLAGE DR SUITE 2
NEWPORT VT
05855-9836
US

V. Phone/Fax

Practice location:
  • Phone: 802-334-4110
  • Fax: 802-334-3281
Mailing address:
  • Phone: 802-334-4110
  • Fax: 802-334-4113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

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