Provider Demographics
NPI:1093753881
Name:PARKLAND PHYSICIAN SERVICES, INC.
Entity Type:Organization
Organization Name:PARKLAND PHYSICIAN SERVICES, INC.
Other - Org Name:PARKLAND PHYSICIAN SERVICES OF SALEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:V.P.
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-894-0500
Mailing Address - Street 1:18 PELHAM RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-4818
Mailing Address - Country:US
Mailing Address - Phone:603-894-0500
Mailing Address - Fax:603-894-0535
Practice Address - Street 1:18 PELHAM RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-4818
Practice Address - Country:US
Practice Address - Phone:603-894-0500
Practice Address - Fax:603-894-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12997174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty