Healthcare Provider Details

I. General information

NPI: 1295287936
Provider Name (Legal Business Name): RUTLAND HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2016
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 ALLEN ST
RUTLAND VT
05701-4560
US

IV. Provider business mailing address

160 ALLEN ST
RUTLAND VT
05701-4560
US

V. Phone/Fax

Practice location:
  • Phone: 802-747-1777
  • Fax: 802-747-3994
Mailing address:
  • Phone: 802-775-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number038.0124175
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER BERTRAND
Title or Position: CFO
Credential:
Phone: 802-775-7111