Provider Demographics
NPI:1275575458
Name:HUTCHINSON MEDICAL
Entity Type:Organization
Organization Name:HUTCHINSON MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:LYONS
Authorized Official - Last Name:MCAULIFFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-741-1770
Mailing Address - Street 1:333 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-1738
Mailing Address - Country:US
Mailing Address - Phone:978-741-1770
Mailing Address - Fax:978-741-1330
Practice Address - Street 1:56 OLD SUNCOOK RD
Practice Address - Street 2:#6
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5127
Practice Address - Country:US
Practice Address - Phone:603-224-8533
Practice Address - Fax:603-224-8531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH462590332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30005915Medicaid
NH0171810002Medicare NSC