Provider Demographics
NPI:1225061310
Name:CHESHIRE MEDICAL CENTER
Entity Type:Organization
Organization Name:CHESHIRE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:K
Authorized Official - Last Name:LENT
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:603-354-5454
Mailing Address - Street 1:PO BOX 65
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03443-0065
Mailing Address - Country:US
Mailing Address - Phone:603-363-8405
Mailing Address - Fax:
Practice Address - Street 1:590 COURT ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1719
Practice Address - Country:US
Practice Address - Phone:603-354-5454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH029044-23-04261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility