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General NPI Number Information
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NPI Number | 1750596110
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Entity Type | Organization
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Legal Business Name | BENNINGTON COLLEGE HEALTH SERVICES
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1 COLLEGE DRIVE
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City | BENNINGTON
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State | VT
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Zip | 05201-0006
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Country | US
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Telephone | 802-440-4426
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Fax | 802-440-4427
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Provider Business Mailing Address
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Address Line | 1 COLLEGE DRIVE
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City | BENNINGTON
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State | VT
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Zip | 05201-0006
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Country | US
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Telephone | 802-440-4426
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Fax | 802-440-4427
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Authorized Official
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Title or Position | DIRECTOR OF HEALTH SERVICES
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Name | DR. RANDALL S ANSELMO
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Credential | MD
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Telephone | 802-440-4426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0260009599
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0260008617
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0260029265
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License Number State | VT
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0420010651
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License Number State | VT
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