Provider Demographics
NPI:1679642482
Name:LITTLETON HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:LITTLETON HOSPITAL ASSOCIATION
Other - Org Name:LITTLETON REGIONAL HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-444-9504
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-0160
Mailing Address - Country:US
Mailing Address - Phone:603-444-9000
Mailing Address - Fax:603-444-9392
Practice Address - Street 1:600 SAINT JOHNSBURY RD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-3442
Practice Address - Country:US
Practice Address - Phone:603-444-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02790275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME138260000Medicaid
NH301302OtherANTHEM BCBS PROVIDER #
NH322017OtherMVP PROVIDER #
VT0000783Medicaid
RI0300008Medicaid
NH54141OtherCIGNA PROVIDER #
MA7003629Medicaid
NH80300008Medicaid
RIOP13013Medicaid
NY01729235Medicaid
VT0301302Medicaid
MA7100353Medicaid
NH301302OtherANTHEM BCBS PROVIDER #