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Organization

NORTHEASTERN VERMONT REGIONAL HOSPITAL INC

Active
Other names
NVRH KINGDOM INTERNAL MEDICINE
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT N HERSEY (CFO)
(802) 748-7520
Entity
Organization

Contact information

Practice address
714 BREEZY HILL ROAD, ST JOHNSBURY, VT 05819-0905
(805) 748-7500
(802) 745-1188
Mailing address
PO BOX 905, ST JOHNSBURY, VT 05819-0905
(802) 748-8141
(802) 748-4098

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
261QP2300X
Primary Care Clinic/Center
261QR1300X
Rural Health Clinic/Center
Primary
785
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0473991
VT
05
1020004
VT
05
3076793
NH
Enumeration date
11/04/2011
Last updated
02/11/2020
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