Organization
NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Active
Other names
Family Practice of Newport
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT L FOTTER (CHIEF FINANICAL OFFICER)
(802) 334-4111
Entity
Organization
Contact information
Practice address
81 MEDICAL VILLAGE DR, SUITE 1, NEWPORT, VT 05855-9835
(802) 334-4120
(802) 334-3281
Mailing address
189 PROUTY DR, NEWPORT, VT 05855-9326
(802) 334-4111
(802) 334-3281
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0473980
—
VT
05
—
0VN1031
—
VT
01
—
8000698
LADIES FIRST
VT
01
—
CA2785
RAILROAD MEDICARE
VT
01
—
NORT00029083
BLUE SHIELD
VT
Enumeration date
02/08/2007
Last updated
04/20/2008
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