Provider Demographics
NPI:1669443008
Name:SPRINGFIELD HOSPITAL
Entity Type:Organization
Organization Name:SPRINGFIELD HOSPITAL
Other - Org Name:LUDLOW HEALTH CENTER
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 1:1 ELM ST
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:VT
Mailing Address - Zip Code:05149-1301
Mailing Address - Country:US
Mailing Address - Phone:802-228-8867
Mailing Address - Fax:
Practice Address - Street 1:1 ELM ST
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:VT
Practice Address - Zip Code:05149-1301
Practice Address - Country:US
Practice Address - Phone:802-228-8867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT9838Medicaid
VT0473975Medicaid
VTVT9838Medicare ID - Type Unspecified
VT9838Medicaid
VT0726800001Medicare NSC