Provider Demographics
NPI: | 1477530376 |
---|---|
Name: | CORE HEALTH SERVICES INC |
Entity Type: | Organization |
Organization Name: | CORE HEALTH SERVICES INC |
Other - Org Name: | CORE PHYSICIAN SERVICES |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DEBRA |
Authorized Official - Middle Name: | R |
Authorized Official - Last Name: | CRESTA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 603-580-6693 |
Mailing Address - Street 1: | PO BOX 655 |
Mailing Address - Street 2: | |
Mailing Address - City: | EXETER |
Mailing Address - State: | NH |
Mailing Address - Zip Code: | 03833 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 603-580-6753 |
Mailing Address - Fax: | 603-580-6840 |
Practice Address - Street 1: | 21 HAMPTON ROAD |
Practice Address - Street 2: | |
Practice Address - City: | EXETER |
Practice Address - State: | NH |
Practice Address - Zip Code: | 03833 |
Practice Address - Country: | US |
Practice Address - Phone: | 603-580-6753 |
Practice Address - Fax: | 603-580-6840 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2005-12-30 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Not Answered | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
Not Answered | 207QS0010X | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | Group - Multi-Specialty |
Not Answered | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
Not Answered | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
Not Answered | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
Not Answered | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
Not Answered | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
Not Answered | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
Not Answered | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
Not Answered | 208200000X | Allopathic & Osteopathic Physicians | Plastic Surgery | Group - Multi-Specialty | |
Not Answered | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
Not Answered | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
Not Answered | 208C00000X | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery | Group - Multi-Specialty | |
Not Answered | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
Not Answered | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NH | 80008636 | Medicaid | |
NH | 80008636 | Medicaid |