Provider Demographics
NPI:1134401599
Name:SOUTHWESTERN VERMONT MEDICAL CENTER, INC
Entity type:Organization
Organization Name:SOUTHWESTERN VERMONT MEDICAL CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-442-6361
Mailing Address - Street 1:100 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-5004
Mailing Address - Country:US
Mailing Address - Phone:802-442-6361
Mailing Address - Fax:
Practice Address - Street 1:13 GRAND SUMMIT WAY
Practice Address - Street 2:
Practice Address - City:WEST DOVER
Practice Address - State:VT
Practice Address - Zip Code:05356
Practice Address - Country:US
Practice Address - Phone:802-464-9300
Practice Address - Fax:802-464-9314
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWESTERN VERMONT MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty