Provider Demographics
NPI:1194016162
Name:LRGHEALTHCARE
Entity Type:Organization
Organization Name:LRGHEALTHCARE
Other - Org Name:ENT ASSOCIATES OF NH, A DEPT OF LAKES REGION GENERAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP-CFO
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:LIPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-527-2802
Mailing Address - Street 1:PO BOX 2010
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-2010
Mailing Address - Country:US
Mailing Address - Phone:603-524-3211
Mailing Address - Fax:603-527-7038
Practice Address - Street 1:85 SPRING ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3113
Practice Address - Country:US
Practice Address - Phone:603-524-7402
Practice Address - Fax:603-524-0945
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LRGHEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty