Organization
NORTH COUNTRY HOSPITAL & HEALTH SYSTEMS INC
Active
Other names
North Country Urology Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDRE BISSONNETT (CFO)
(802) 334-4111
Entity
Organization
Contact information
Practice address
189 PROUTY DR, NEWPORT, VT 05855-9326
(802) 334-4111
(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
207R00000X
Internal Medicine Physician
Primary
—
—
207RH0003X
Hematology & Oncology Physician
—
—
208800000X
Urology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
042-0010304
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008679
—
VT
05
—
1009352
—
VT
05
—
30201717
—
NH
01
—
CA2785
RAILROAD MEDICARE
VT
01
—
NORT00058438
BLUE SHIELD
VT
01
—
NORT00058665
BLUE SHIELD
VT
Enumeration date
03/08/2007
Last updated
04/10/2009
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