Basic Information
| Provider Information | |||||||||
| NPI: | 1962598797 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PORTER HOSPITAL INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 115 PORTER DR | ||||||||
| Address2: | FINANCE DEPT | ||||||||
| City: | MIDDLEBURY | ||||||||
| State: | VT | ||||||||
| PostalCode: | 05753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8023885682 | ||||||||
| FaxNumber: | 8023885696 | ||||||||
| Practice Location | |||||||||
| Address1: | 115 PORTER DR | ||||||||
| Address2: | PORTER HOSPITAL | ||||||||
| City: | MIDDLEBURY | ||||||||
| State: | VT | ||||||||
| PostalCode: | 05753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8023885682 | ||||||||
| FaxNumber: | 8023885696 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 02/13/2017 | ||||||||
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| AuthorizedOfficialLastName: | BERTRAND | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8023884752 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | 867 | VT | N | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care | 261QE0002X | 675 | VT | Y | Ambulatory Health Care Facilities | Clinic/Center | Emergency Care |
No ID Information.