Provider Demographics
NPI:1679533582
Name:MARTIN'S POINT HEALTH CARE, INC
Entity Type:Organization
Organization Name:MARTIN'S POINT HEALTH CARE, INC
Other - Org Name:PORTSMOUTH PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PORTSMOUTH PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:NADEAU-LEAVITT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:603-436-0562
Mailing Address - Street 1:161 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-6825
Mailing Address - Country:US
Mailing Address - Phone:603-436-0562
Mailing Address - Fax:603-427-6155
Practice Address - Street 1:161 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-6825
Practice Address - Country:US
Practice Address - Phone:603-436-0562
Practice Address - Fax:603-427-6155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
NH0416P333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
3005178OtherNCPDP#
BM3977381OtherDEA#
0945000004Medicare NSC