Provider Demographics
NPI:1437291515
Name:SPEARE MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:SPEARE MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCEWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-536-1120
Mailing Address - Street 1:16 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-1126
Mailing Address - Country:US
Mailing Address - Phone:603-238-2204
Mailing Address - Fax:603-536-2034
Practice Address - Street 1:16 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-1126
Practice Address - Country:US
Practice Address - Phone:603-536-1104
Practice Address - Fax:603-536-7260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH01300261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30009400Medicaid
VT0RE4129Medicaid
NH3083073Medicaid
VT0RE4129Medicaid
RE4129Medicare PIN