Provider Demographics
NPI:1508093360
Name:NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Entity Type:Organization
Organization Name:NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Other - Org Name:ORLEANS FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:BISSONNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-334-3253
Mailing Address - Street 1:189 PROUTY DRIVE
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:802-754-2220
Mailing Address - Fax:802-754-2195
Practice Address - Street 1:30 EAST STREET
Practice Address - Street 2:
Practice Address - City:ORLEANS
Practice Address - State:VT
Practice Address - Zip Code:05860-1240
Practice Address - Country:US
Practice Address - Phone:802-754-2220
Practice Address - Fax:802-754-2195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 332B00000X
VT261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty