Provider Demographics
NPI:1366646234
Name:ELLIOT HOSPITAL
Entity Type:Organization
Organization Name:ELLIOT HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR PATIENT FINANCIAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-663-2431
Mailing Address - Street 1:1050 HOLT AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-5615
Mailing Address - Country:US
Mailing Address - Phone:603-622-3781
Mailing Address - Fax:603-663-5820
Practice Address - Street 1:1050 HOLT AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03109-5615
Practice Address - Country:US
Practice Address - Phone:603-622-3781
Practice Address - Fax:603-663-5820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0510P3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80002306Medicaid
NH1207512Y0NH01OtherANTHEM
NH2609052Y0NH01OtherANTHEM
NH80002306Medicaid