Provider Demographics
NPI:1962016808
Name:ALTRIX PRIMARY CARE - NASHUA LLC
Entity Type:Organization
Organization Name:ALTRIX PRIMARY CARE - NASHUA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DUPONT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-440-8048
Mailing Address - Street 1:101 TURKEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-4020
Mailing Address - Country:US
Mailing Address - Phone:603-440-8048
Mailing Address - Fax:
Practice Address - Street 1:57 NORTHEASTERN BLVD STE 202
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-3154
Practice Address - Country:US
Practice Address - Phone:603-440-8048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty