Provider Demographics
NPI:1104868892
Name:NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Entity type:Organization
Organization Name:NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ENROLLMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-334-3210
Mailing Address - Street 1:189 PROUTY DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-9326
Mailing Address - Country:US
Mailing Address - Phone:802-334-7331
Mailing Address - Fax:802-334-3281
Practice Address - Street 1:488 ELM ST
Practice Address - Street 2:
Practice Address - City:BARTON
Practice Address - State:VT
Practice Address - Zip Code:05822-8637
Practice Address - Country:US
Practice Address - Phone:802-525-3539
Practice Address - Fax:802-525-3088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0473987Medicaid
VTNORT00029083OtherBLUE SHIELD
VT0VN1505Medicaid
VTCA2318OtherMEDICARE RR
VT101315300OtherWC - US DEPT OF LABOR
VT8000697OtherLADIES FIRST
VT101315300OtherWC - US DEPT OF LABOR
VT8000697OtherLADIES FIRST
VTVN1505Medicare ID - Type UnspecifiedMEDICARE B
VT473987Medicare Oscar/Certification