Provider Demographics
NPI:1114251295
Name:LANDMARK FAMILY HEALTHCARE
Entity Type:Organization
Organization Name:LANDMARK FAMILY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROMBOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-425-6494
Mailing Address - Street 1:50 NASHUA RD STE 301
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3444
Mailing Address - Country:US
Mailing Address - Phone:603-425-6494
Mailing Address - Fax:603-425-2048
Practice Address - Street 1:50 NASHUA RD STE 301
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3444
Practice Address - Country:US
Practice Address - Phone:603-425-6494
Practice Address - Fax:603-425-2048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH05212923302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization