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DSH470005F RUTLAND REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
RUTLAND REGIONAL MEDICAL CENTER
Subdivision Name
Vermont Orthopaedic Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH470005F
Medicare Provider Number
470005
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/1/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/14/2016
Last Recertification Date
8/31/2020
Termination Date
Termination Reason
10/1/2020
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Rutland Regional Medical Center
Judi K Fox, CFO
(802) 747-1632
Primary Contact
Rutland Regional Medical Center
Jonathan Reynolds, VP Clinical Services
(802) 772-2634
Addresses
Street Address
3 Albert Cree Drive
Rutland, VT 05701
Billing Address
Rutland Regional Medical Center
160 Allen St
Rutland, VT 05701
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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