Provider Demographics
NPI:1669462792
Name:ST JOSEPH HOSPITAL OF NASHUA NH
Entity Type:Organization
Organization Name:ST JOSEPH HOSPITAL OF NASHUA NH
Other - Org Name:INPATIENT REHABILITATION
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:PLAMONDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-882-3000
Mailing Address - Street 1:PO BOX 95000 LBX 7655
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-0001
Mailing Address - Country:US
Mailing Address - Phone:207-777-8202
Mailing Address - Fax:207-783-6660
Practice Address - Street 1:172 KINSLEY ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3648
Practice Address - Country:US
Practice Address - Phone:603-882-3000
Practice Address - Fax:603-889-1651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH00023273Y00000X
273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30T011Medicare ID - Type Unspecified
NHNH0815Medicare PIN
NHNH0637Medicare PIN
NHNH0813Medicare PIN