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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