Provider Demographics
NPI:1407038995
Name:LACONIA WOMEN'S HEALTH CENTER, PLLC
Entity Type:Organization
Organization Name:LACONIA WOMEN'S HEALTH CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:DIRUBBO
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:603-528-4304
Mailing Address - Street 1:501 UNION AVE
Mailing Address - Street 2:SUITE #3
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2867
Mailing Address - Country:US
Mailing Address - Phone:603-528-4304
Mailing Address - Fax:
Practice Address - Street 1:501 UNION AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2867
Practice Address - Country:US
Practice Address - Phone:603-528-4304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE3128Medicare PIN