Provider Demographics
NPI:1568459931
Name:HUGGINS HOSPITAL
Entity Type:Organization
Organization Name:HUGGINS HOSPITAL
Other - Org Name:WOLFEBORO FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROBERGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-569-7510
Mailing Address - Street 1:240 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOLFEBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03894-4411
Mailing Address - Country:US
Mailing Address - Phone:603-569-7574
Mailing Address - Fax:603-569-7582
Practice Address - Street 1:240 S MAIN ST
Practice Address - Street 2:MEDICAL ARTS BUILDING, SUITE A
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894-4411
Practice Address - Country:US
Practice Address - Phone:603-569-7574
Practice Address - Fax:603-569-7582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RE8642OtherMEDICARE PAT B
NH308556Medicaid