Provider Demographics
NPI:1912053794
Name:NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Entity Type:Organization
Organization Name:NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENROLLMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-334-3210
Mailing Address - Street 1:189 PROUTY DR
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:802-334-7331
Mailing Address - Fax:802-334-3281
Practice Address - Street 1:189 PROUTY DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-9326
Practice Address - Country:US
Practice Address - Phone:802-334-7331
Practice Address - Fax:802-334-3281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT688275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT470008OtherBLUE SHIELD
VT047Z304Medicaid
VT470008OtherBLUE SHIELD