Provider Demographics
NPI:1033705249
Name:SURGICAL ASSISTANTS OF NEW HAMPSHIRE LLC
Entity Type:Organization
Organization Name:SURGICAL ASSISTANTS OF NEW HAMPSHIRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/SURGICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:901-831-2500
Mailing Address - Street 1:3 EXECUTIVE PARK DR STE 201
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6954
Mailing Address - Country:US
Mailing Address - Phone:603-836-3498
Mailing Address - Fax:
Practice Address - Street 1:3 EXECUTIVE PARK DR STE 201
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6954
Practice Address - Country:US
Practice Address - Phone:603-836-3498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-12
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty