Provider Demographics
NPI:1437376209
Name:AMMONOOSUC COMMUNITY HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:AMMONOOSUC COMMUNITY HEALTH SERVICES, INC.
Other - Org Name:AMMONOOSUC COMMUNITY HEALTH SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORRINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-444-2464
Mailing Address - Street 1:25 MOUNT EUSTIS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-3712
Mailing Address - Country:US
Mailing Address - Phone:603-444-2464
Mailing Address - Fax:603-444-3441
Practice Address - Street 1:79 SWIFTWATER RD
Practice Address - Street 2:
Practice Address - City:WOODSVILLE
Practice Address - State:NH
Practice Address - Zip Code:03785-1447
Practice Address - Country:US
Practice Address - Phone:603-747-3740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMMONOOSUC COMMUNITY HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-20
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80301805Medicaid
NHRE2692Medicare PIN
NH301805Medicare ID - Type Unspecified
NH80301805Medicaid
NH301805Medicare Oscar/Certification