Provider Demographics
NPI:1821110610
Name:WHITE MOUNTAIN ORTHOPEDICS INC
Entity Type:Organization
Organization Name:WHITE MOUNTAIN ORTHOPEDICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARTSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:603-279-8989
Mailing Address - Street 1:173 NH ROUTE 104
Mailing Address - Street 2:
Mailing Address - City:MEREDITH
Mailing Address - State:NH
Mailing Address - Zip Code:03253-5730
Mailing Address - Country:US
Mailing Address - Phone:603-279-8989
Mailing Address - Fax:603-279-7711
Practice Address - Street 1:173 NH ROUTE 104
Practice Address - Street 2:
Practice Address - City:MEREDITH
Practice Address - State:NH
Practice Address - Zip Code:03253-5730
Practice Address - Country:US
Practice Address - Phone:603-279-8989
Practice Address - Fax:603-279-7711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80547671Medicaid
0208100001Medicare ID - Type Unspecified