Provider Demographics
NPI:1013069376
Name:STRAFFORD HEALTH ALLIANCE
Entity type:Organization
Organization Name:STRAFFORD HEALTH ALLIANCE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAUDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-742-6673
Mailing Address - Street 1:200 ROUTE 108
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-1119
Mailing Address - Country:US
Mailing Address - Phone:603-742-7492
Mailing Address - Fax:603-742-6762
Practice Address - Street 1:200 ROUTE 108
Practice Address - Street 2:SUITE 3
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1119
Practice Address - Country:US
Practice Address - Phone:603-742-7492
Practice Address - Fax:603-742-6762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M2300XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMammographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH155010OtherFDA CERTIFICATE #
NH30M005Medicare ID - Type UnspecifiedCERTIFIED SCREENING CENTR