Provider Demographics
NPI:1467743427
Name:LRGHEALTHCARE
Entity Type:Organization
Organization Name:LRGHEALTHCARE
Other - Org Name:ADVANCED ORTHOPAEDIC SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP-CFO
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:LIPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-527-2802
Mailing Address - Street 1:PO BOX 2011
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-2011
Mailing Address - Country:US
Mailing Address - Phone:603-524-3211
Mailing Address - Fax:603-527-7038
Practice Address - Street 1:14 MAPLE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:GILFORD
Practice Address - State:NH
Practice Address - Zip Code:03249-6580
Practice Address - Country:US
Practice Address - Phone:603-528-9011
Practice Address - Fax:603-527-5743
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LRGHEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8510207X00000X
NH332M2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30218923Medicaid
NH002349201Medicare PIN