Provider Demographics
NPI:1114237187
Name:SPEARE MEMORIAL HOSP PHCY DEPT
Entity Type:Organization
Organization Name:SPEARE MEMORIAL HOSP PHCY DEPT
Other - Org Name:SPEARE MEMORIAL HOSPITAL PHARMACY DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASCUDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:603-238-2226
Mailing Address - Street 1:16 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-1126
Mailing Address - Country:US
Mailing Address - Phone:603-238-2226
Mailing Address - Fax:603-238-6419
Practice Address - Street 1:16 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-1126
Practice Address - Country:US
Practice Address - Phone:603-238-2226
Practice Address - Fax:603-238-6419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH00573336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3002223OtherNCPDP PROVIDER IDENTIFICATION NUMBER