NORTH COUNTRY HOSPITAL & HEALTH CENTER INC

Provider Demographics

• NPI: 1295868008
• Name: NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
• Entity Type: Organization
• Organization Name: NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
• Other - Org Name: NORTH COUNTRY OB GYN SERVICES
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: ENROLLMENT SPECIALIST
• Authorized Official - First Name: DEBORAH
• Authorized Official - Middle Name: L
• Authorized Official - Last Name: BROWN
• Authorized Official - Phone: 802-334-3210
• Mailing Address - Street 1: 81 MEDICAL VILLAGE DR
• Mailing Address - Street 2: SUITE 2
• Mailing Address - City: NEWPORT
• Mailing Address - State: VT
• Mailing Address - Zip Code: 05855-9836
• Mailing Address - Country: US
• Mailing Address - Phone: 802-334-4110
• Mailing Address - Fax: 802-334-4113
• Practice Address - Street 1: 81 MEDICAL VILLAGE DR STE 2
• Practice Address - City: NEWPORT
• Practice Address - State: VT
• Practice Address - Zip Code: 05855-9897
• Practice Address - Country: US
• Practice Address - Phone: 802-334-4110
• Practice Address - Fax: 802-334-3281
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-03-13
• Last Update Date: 2023-09-12

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207V00000X	Allopathic & Osteopathic Physicians	Obstetrics & Gynecology		Group - Single Specialty
No	261QR1300X	Ambulatory Health Care Facilities	Clinic/Center	Rural Health
No	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies		Group - Single Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
VT	0473982	Medicaid
VT	OVN0584	Medicaid
VT	015608544	Other	HARVARD PILGRAM HEALTH PL
VT	8000747	Other	LADIES FIRST DEPT OF HEAL
VT	NORT00029083	Other	BLUE SHIELD OF VERMONT
VT	101315300	Other	DEPT OF LABOR WORKERS COM
NH	30008005	Medicaid
VT	CG5262	Other	RAILROAD MEDICARE
VT	NORT00029083	Other	BLUE SHIELD OF VERMONT
VT	VN0584	Medicare ID - Type Unspecified
NH	30008005	Medicaid