Provider Demographics
NPI:1225029267
Name:LINWOOD MEDICAL CENTER
Entity Type:Organization
Organization Name:LINWOOD MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:WETHERELL
Authorized Official - Suffix:
Authorized Official - Credentials:NRP
Authorized Official - Phone:603-745-3904
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:NORTH WOODSTOCK
Mailing Address - State:NH
Mailing Address - Zip Code:03262
Mailing Address - Country:US
Mailing Address - Phone:800-488-4351
Mailing Address - Fax:
Practice Address - Street 1:12 PROFILE DRIVE
Practice Address - Street 2:
Practice Address - City:NORTH WOODSTOCK
Practice Address - State:NH
Practice Address - Zip Code:03262
Practice Address - Country:US
Practice Address - Phone:603-745-3904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0064341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
590014549OtherRR MEDICARE
7106325Y0NH01OtherANTHEM BCBS
802261OtherTUFTS HEALTH PLAN
NH83013959Medicaid
607281100OtherDEPARTMENT OF LABOR
700659OtherHARVARD PILGRIM
590014549OtherRR MEDICARE