Provider Demographics
NPI:1609035310
Name:SPRINGFIELD HOSPITAL
Entity Type:Organization
Organization Name:SPRINGFIELD HOSPITAL
Other - Org Name:SPRINGFIELD SPECIALTY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-885-2151
Mailing Address - Street 1:252 RIVER ST
Mailing Address - Street 2:C/O NETWORK MANAGEMENT SERVICES
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-2306
Mailing Address - Country:US
Mailing Address - Phone:802-885-5785
Mailing Address - Fax:802-885-2030
Practice Address - Street 1:29 RIDGEWOOD RD
Practice Address - Street 2:SPRINGFIELD SPECIALTY PHYSICIANS
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-3050
Practice Address - Country:US
Practice Address - Phone:802-885-6373
Practice Address - Fax:802-885-6375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN1222Medicaid
VTOVN1222Medicaid