Organization
NORTHEASTERN VERMONT REGIONAL HOSPITAL DIETARY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT N HERSEY (CFO)
(802) 748-8141
Entity
Organization
Contact information
Practice address
1315 HOSPITAL DR, ST JOHNSBURY, VT 05819-9210
(802) 748-8141
(802) 748-4098
Mailing address
1315 HOSPITAL DR, ST JOHNSBURY, VT 05819-9210
(802) 748-8141
(802) 748-4098
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
673
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00069029
BLUECROSS BLUESHIELD VT
VT
Enumeration date
06/14/2006
Last updated
08/22/2020
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