Organization
GIFFORD MEDICAL CENTER
Active
Other names
Ansthesiology
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL K COSTA (CEO)
(802) 728-2211
Entity
Organization
Contact information
Practice address
44 S MAIN ST, RANDOLPH, VT 05060-1381
(802) 728-7000
(802) 728-2394
Mailing address
44 S MAIN ST, RANDOLPH, VT 05060-1381
(802) 728-7000
(802) 728-2394
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
VT
282N00000X
General Acute Care Hospital
Primary
—
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5839
BLUE CROSS
VT
Enumeration date
03/28/2007
Last updated
07/01/2025
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