Provider Demographics
NPI:1528213428
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:
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 1:103 BOULDER POINT DR
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-3168
Practice Address - Country:US
Practice Address - Phone:603-536-1565
Practice Address - Fax:603-536-1200
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPEARE MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-20
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0009161Medicaid
NH3077000Medicaid
NH0009161Medicare PIN
NH3077000Medicaid
NH301311Medicare Oscar/Certification