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Organization
BRATTLEBORO MEMORIAL HOSPITAL
Active
Organization
BRATTLEBORO MEMORIAL HOSPITAL
Active
Other names
BRATTLEBORO MEMORIAL HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
REINA CHAMPNEY (CREDENTIALING MANAGER)
(802) 257-8203
Entity
Organization
Contact information
Practice address
17 BELMONT AVE, BRATTLEBORO, VT 05301-3498
(802) 257-0341
(802) 257-8834
Mailing address
17 BELMONT AVE, BRATTLEBORO, VT 05301-3498
(802) 257-0341
(802) 257-8834
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
207YX0602X
Otolaryngic Allergy Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
282N00000X
General Acute Care Hospital
Primary
648
VT
282N00000X
General Acute Care Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005692
—
VT
05
—
0470011
—
VT
05
—
3081119
—
NH
01
—
470011
BLUE CROSS PROVIDER #
VT
Enumeration date
05/31/2005
Last updated
03/23/2022
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