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CAH471303-09 NORTHEASTERN VERMONT REGIONAL HOSPITAL (Active)
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Main Details
Name
NORTHEASTERN VERMONT REGIONAL HOSPITAL
Subdivision Name
NVRH PODIATRY CLINIC - PODIATRY
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH471303-09
Medicare Provider Number
471303
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/10/2024
Participating Start Date
7/1/2024
Participating Approval Date
4/22/2024
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Northeastern Vermont Regional Hospital
Andre Leo Bissonnette, CFO
(802) 748-7520
Primary Contact
Northeastern Vermont Regional Hospital, Inc
Tracey L Herold, 340B Analyst
(802) 748-7583
Addresses
Street Address
1290 HOSPITAL DR
ST JOHNSBURY, VT 05819-9205
Billing Address
NVRH PODIATRY CLINIC _ PODIATRY
1315 Hospital Drive
ST. JOHNSBURY, VT 05819
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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