Provider Demographics
NPI:1417023904
Name:NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Entity Type:Organization
Organization Name:NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Other - Org Name:NORTH COUNTRY PRIMARY CARE NEWPORT
Other - Org Type:Doing Business As
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 1:186 MEDICAL VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-8537
Mailing Address - Country:US
Mailing Address - Phone:802-334-3522
Mailing Address - Fax:802-334-3512
Practice Address - Street 1:186 MEDICAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-8537
Practice Address - Country:US
Practice Address - Phone:802-334-3520
Practice Address - Fax:802-334-3281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0473979Medicaid
VT0VN0873Medicaid
VTNORT00019718OtherBLUE CROSS BLUE SHIELD
VTCN1521OtherRAILROAD MEDICARE
VT8000696OtherLADIES FIRST
VT0VN0873Medicaid
VT8000696OtherLADIES FIRST
VT0473979Medicaid