Provider Demographics
NPI:1679648422
Name:FRISBIE MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:FRISBIE MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WHITE - GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:LISCW
Authorized Official - Phone:603-330-8973
Mailing Address - Street 1:32 TIDEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-4578
Mailing Address - Country:US
Mailing Address - Phone:603-749-4567
Mailing Address - Fax:
Practice Address - Street 1:11 WHITEHALL RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-3226
Practice Address - Country:US
Practice Address - Phone:603-335-8177
Practice Address - Fax:603-335-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1126261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHWH RE7100Medicare ID - Type Unspecified