Provider Demographics
NPI:1013121482
Name:PILOT HEALTH, LLC
Entity Type:Organization
Organization Name:PILOT HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FEOLA-MAHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-357-1922
Mailing Address - Street 1:105 CASTLE ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3307
Mailing Address - Country:US
Mailing Address - Phone:603-357-1922
Mailing Address - Fax:603-352-8822
Practice Address - Street 1:105 CASTLE ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3307
Practice Address - Country:US
Practice Address - Phone:603-357-1922
Practice Address - Fax:603-352-8822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03265251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30591446OtherPROVIDER NUMBER