Provider Demographics
NPI:1952503898
Name:NEW HAMPSHIRE DEPARTMENT OF CORRECTIONS
Entity Type:Organization
Organization Name:NEW HAMPSHIRE DEPARTMENT OF CORRECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAFOREST
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:603-271-6480
Mailing Address - Street 1:281 N STATE ST
Mailing Address - Street 2:PO BOX 14
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3227
Mailing Address - Country:US
Mailing Address - Phone:603-271-6480
Mailing Address - Fax:603-271-6479
Practice Address - Street 1:281 N STATE ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3227
Practice Address - Country:US
Practice Address - Phone:603-271-6480
Practice Address - Fax:603-271-6479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0333261QP2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health