Provider Demographics
NPI:1881633923
Name:CENTRAL VERMONT MEDICAL CENTER INC
Entity Type:Organization
Organization Name:CENTRAL VERMONT MEDICAL CENTER INC
Other - Org Name:CVMC-PSYCHIATRIC UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHEYENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-371-4109
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:CVMC-FINANCE DEPT
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-0547
Mailing Address - Country:US
Mailing Address - Phone:802-371-4100
Mailing Address - Fax:802-371-4488
Practice Address - Street 1:130 FISHER RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9516
Practice Address - Country:US
Practice Address - Phone:802-371-4100
Practice Address - Fax:802-371-4488
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL VERMONT MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT666273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT047S001Medicaid
VT47S001Medicare Oscar/Certification