Organization
BENNINGTON COLLEGE HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL S ANSELMO MD (DIRECTOR OF HEALTH SERVICES)
(802) 440-4426
Entity
Organization
Contact information
Practice address
1 COLLEGE DRIVE, BENNINGTON, VT 05201-0006
(802) 440-4426
(802) 440-4427
Mailing address
1 COLLEGE DRIVE, BENNINGTON, VT 05201-0006
(802) 440-4426
(802) 440-4427
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0260008617
VT
163W00000X
Registered Nurse
0260009599
VT
163W00000X
Registered Nurse
Primary
0260029265
VT
207Q00000X
Family Medicine Physician
0420010651
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BENN00005278
BLUE CROSS BLUE SHIELD
VT
01
—
CVT405C
BOLLINGER INC
—
Enumeration date
05/11/2007
Last updated
09/11/2025
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