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General NPI Number Information
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NPI Number | 1831132299
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Entity Type | Organization
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Legal Business Name | NORTHEASTERN VERMONT REGIONAL HOSPITAL, INC
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 02/11/2020
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Provider Practice Location Address
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Address Line | 1315 HOSPITAL DR
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City | ST JOHNSBURY
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State | VT
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Zip | 05819-9210
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Country | US
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Telephone | 802-748-7300
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Fax | 802-748-7321
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Provider Business Mailing Address
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Address Line | PO BOX 905
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City | ST JOHNSBURY
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State | VT
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Zip | 05819-0905
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Country | US
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Telephone | 802-748-8141
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | ROBERT N HERSEY
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Credential |
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Telephone | 802-748-7520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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