Provider Demographics
NPI:1831351451
Name:COPLEY HOSPITAL INC
Entity type:Organization
Organization Name:COPLEY HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MELVYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATASHNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-888-8157
Mailing Address - Street 1:528 WASHINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-8973
Mailing Address - Country:US
Mailing Address - Phone:802-888-8888
Mailing Address - Fax:
Practice Address - Street 1:528 WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-8973
Practice Address - Country:US
Practice Address - Phone:802-888-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT667275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0005776Medicaid
VT1012296Medicaid
VT0005696Medicaid
VT8000452Medicaid
VT0005574Medicaid
VT1012122Medicaid
VTVN3955Medicare Oscar/Certification
VT047Z305Medicare Oscar/Certification
VTVT5574Medicare Oscar/Certification
VT0471305Medicare Oscar/Certification
VTVT5776Medicare Oscar/Certification
VT1012296Medicaid
VT8000452Medicaid
VT0005574Medicaid
VTVT5696Medicare Oscar/Certification