Provider Demographics
NPI:1568480622
Name:SPEARE MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:SPEARE MEMORIAL HOSPITAL
Other - Org Name:TENNEY MOUNTAIN ORTHOPEDICS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:KRITIKOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-536-1120
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03216-0032
Mailing Address - Country:US
Mailing Address - Phone:603-735-6060
Mailing Address - Fax:603-735-6070
Practice Address - Street 1:19 AVERY ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-1130
Practice Address - Country:US
Practice Address - Phone:603-536-5803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9435174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH758313OtherTUFTS
NH30211268Medicaid
VT52028603OtherANTHEM
NHCG6192OtherRAILROAD MEDICARE
NH2874405OtherCIGNA
NH30211268Medicaid
NHRE6164Medicare ID - Type Unspecified