Healthcare Provider Details

I. General information

NPI: 1508093360
Provider Name (Legal Business Name): NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2009
Last Update Date: 06/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 EAST STREET
ORLEANS VT
05860-1240
US

IV. Provider business mailing address

189 PROUTY DRIVE
NEWPORT VT
05855-9326
US

V. Phone/Fax

Practice location:
  • Phone: 802-754-2220
  • Fax: 802-754-2195
Mailing address:
  • Phone: 802-754-2220
  • Fax: 802-754-2195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDRE BISSONNETTE
Title or Position: CFO
Credential:
Phone: 802-334-3253