Healthcare Provider Details

I. General information

NPI: 1417023904
Provider Name (Legal Business Name): NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 MEDICAL VILLAGE DR
NEWPORT VT
05855-8537
US

IV. Provider business mailing address

186 MEDICAL VILLAGE DR
NEWPORT VT
05855-8537
US

V. Phone/Fax

Practice location:
  • Phone: 802-334-3520
  • Fax: 802-334-3281
Mailing address:
  • Phone: 802-334-3522
  • Fax: 802-334-3512

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 Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

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