Provider Demographics
NPI:1275773178
Name:NATHAN H DRUM
Entity Type:Organization
Organization Name:NATHAN H DRUM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:DRUM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:603-788-2031
Mailing Address - Street 1:PO BOX 527
Mailing Address - Street 2:95 MAIN STREET
Mailing Address - City:LANCASTER
Mailing Address - State:NH
Mailing Address - Zip Code:03584-0527
Mailing Address - Country:US
Mailing Address - Phone:603-788-2031
Mailing Address - Fax:603-788-2508
Practice Address - Street 1:95 MAIN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NH
Practice Address - Zip Code:03584-3072
Practice Address - Country:US
Practice Address - Phone:603-788-2031
Practice Address - Fax:603-788-2508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH552152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30010684Medicaid
NHRE0718Medicare UPIN
NH30010684Medicaid