Provider Demographics
NPI:1568421840
Name:CAPITAL ORTHOPEDIC SURGERY CENTER
Entity Type:Organization
Organization Name:CAPITAL ORTHOPEDIC SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-228-7211
Mailing Address - Street 1:PO BOX 10179
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-0179
Mailing Address - Country:US
Mailing Address - Phone:603-724-2444
Mailing Address - Fax:603-724-2581
Practice Address - Street 1:116 LANGLEY PARKWAY
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-228-7211
Practice Address - Fax:603-228-7192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02816261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30621577Medicaid
NH490005259OtherRAILROAD MEDICARE
NH610747700OtherUS DEPT OF LABOR
NH699403OtherTUFTS
NH18Y002249NH01OtherANTHEM BLUE CROSS
NH30621577Medicaid