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CAH471303-08 NORTHEASTERN VERMONT REGIONAL HOSPITAL (Active)
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Main Details
Name
NORTHEASTERN VERMONT REGIONAL HOSPITAL
Subdivision Name
NVRH Pulmonology Clinic - Pulmonology
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH471303-08
Medicare Provider Number
471303
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/9/2024
Participating Start Date
4/1/2024
Participating Approval Date
1/18/2024
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, LOWR LEVEL
ST JOHNSBURY, VT 05819
Billing Address
Northeastern Vermont Regional Hospital
PO Box 905
St Johnsbury, VT 05819
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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