Provider Demographics
NPI:1073636700
Name:SPRINGFIELD HOSPITAL INC.
Entity Type:Organization
Organization Name:SPRINGFIELD HOSPITAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE CREDENTIALING COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-886-8953
Mailing Address - Street 1:25 RIDGEWOOD RD
Mailing Address - Street 2:PO BOX 2003
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-3050
Mailing Address - Country:US
Mailing Address - Phone:802-885-2151
Mailing Address - Fax:802-885-7396
Practice Address - Street 1:18 OLD TERRACE
Practice Address - Street 2:
Practice Address - City:BELLOWS FALLS
Practice Address - State:VT
Practice Address - Zip Code:05101
Practice Address - Country:US
Practice Address - Phone:802-463-1292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPRINGFIELD MEDICAL CARE SYSTEMS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-09
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X
VT694283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes283Q00000XHospitalsPsychiatric Hospital
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT47M306Medicare ID - Type UnspecifiedPHYCH (WINDHAM CENTER)