Provider Demographics
NPI:1619053618
Name:CONCORD HOSPITAL-LACONIA
Entity Type:Organization
Organization Name:CONCORD HOSPITAL-LACONIA
Other - Org Name:LAKES REGION GENERAL HOSPITAL - SWING BED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:W
Authorized Official - Last Name:SLOANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-227-7000
Mailing Address - Street 1:PO BOX 678
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-0678
Mailing Address - Country:US
Mailing Address - Phone:603-524-3211
Mailing Address - Fax:
Practice Address - Street 1:80 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3235
Practice Address - Country:US
Practice Address - Phone:603-524-3211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONCORD HOSPITAL-LACONIA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-31
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH00061275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH10011OtherCIGNA
NH3127643Medicaid
NH30U005Medicare ID - Type Unspecified