Provider Demographics
NPI:1144223702
Name:LITTLETON HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:LITTLETON HOSPITAL ASSOCIATION
Other - Org Name:LITTLETON REGIONAL HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-444-9505
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561
Mailing Address - Country:US
Mailing Address - Phone:603-444-9000
Mailing Address - Fax:
Practice Address - Street 1:600 ST JOHNSBURY RD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561
Practice Address - Country:US
Practice Address - Phone:603-444-9395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02790282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0300008Medicaid
MA7003625Medicaid
MA7100353Medicaid
ME138260000Medicaid
NY0287Medicaid
NH301302OtherANTHEM BCBS PROV #
RIOP13013Medicaid
VT0301302Medicaid
NH54141OtherCIGNA PROVIDER #
NH80300008Medicaid
VT0000783Medicaid
NY0285Medicaid
NY0285Medicaid
NHNH0783Medicare PIN
VT0301302Medicaid
MA7100353Medicaid
NHNH0627Medicare PIN
NHRE3748Medicare PIN