Provider Demographics
NPI:1760555064
Name:UPPER CONNECTICUT VALLEY HOSPITAL ASSOCIATION
Entity type:Organization
Organization Name:UPPER CONNECTICUT VALLEY HOSPITAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, COMPLIANCE AND RISK
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LANDRY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CPCO
Authorized Official - Phone:603-326-5608
Mailing Address - Street 1:181 CORLISS LANE
Mailing Address - Street 2:
Mailing Address - City:COLEBROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03576
Mailing Address - Country:US
Mailing Address - Phone:603-237-4971
Mailing Address - Fax:603-237-4452
Practice Address - Street 1:181 CORLISS LANE
Practice Address - Street 2:
Practice Address - City:COLEBROOK
Practice Address - State:NH
Practice Address - Zip Code:03576
Practice Address - Country:US
Practice Address - Phone:603-237-4971
Practice Address - Fax:603-237-4452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0301300OtherCAH ACUTE
NH80300033Medicaid
926356OtherMVP
VT301300OtherVTW
5129902OtherVMC
80300033OtherNHW
ME138560000Medicaid
CIGNAOther0049127
RI0059200Medicaid
301300OtherANTHEM
VT301300OtherBCBS
VT301300OtherVTW
5129902OtherVMC
301300OtherANTHEM