Provider Demographics
NPI:1235370057
Name:CATHOLIC MEDICAL CENTER
Entity Type:Organization
Organization Name:CATHOLIC MEDICAL CENTER
Other - Org Name:THE SURGICAL CARE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:THERRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-663-8779
Mailing Address - Street 1:87 MCGREGOR ST
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3765
Mailing Address - Country:US
Mailing Address - Phone:603-627-1887
Mailing Address - Fax:
Practice Address - Street 1:87 MCGREGOR ST
Practice Address - Street 2:SUITE 3100
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3765
Practice Address - Country:US
Practice Address - Phone:603-627-1887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty