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General NPI Number Information
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NPI Number | 1366528366
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Entity Type | Organization
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Legal Business Name | NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 01/05/2008
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Provider Practice Location Address
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Address Line | 189 PROUTY DR
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City | NEWPORT
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State | VT
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Zip | 05855-9326
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Country | US
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Telephone | 802-334-3262
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Fax | 802-334-3223
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Provider Business Mailing Address
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Address Line | 189 PROUTY DR
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City | NEWPORT
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State | VT
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Zip | 05855-9326
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Country | US
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Telephone | 802-334-3262
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Fax | 802-334-3223
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | MR. ROBERT L FOTTER
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Credential |
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Telephone | 802-334-3271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 042-0011226
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License Number State | VT
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