Provider Demographics
| NPI: | 1083654941 |
|---|---|
| Name: | CH DHC INC |
| Entity type: | Organization |
| Organization Name: | CH DHC INC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | DIRECTOR, BILLING OPERATIONS |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | BARBARA |
| Authorized Official - Middle Name: | E |
| Authorized Official - Last Name: | MOORE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 603-650-3709 |
| Mailing Address - Street 1: | PO BOX 10493 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BEDFORD |
| Mailing Address - State: | NH |
| Mailing Address - Zip Code: | 03110-0493 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 603-629-1263 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 253 PLEASANT ST |
| Practice Address - Street 2: | |
| Practice Address - City: | CONCORD |
| Practice Address - State: | NH |
| Practice Address - Zip Code: | 03301-7560 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 603-226-2200 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-06-08 |
| Last Update Date: | 2013-06-17 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 207K00000X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Group - Multi-Specialty | |
| No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
| No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
| No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
| No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
| No | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | Group - Multi-Specialty |
| No | 2080P0202X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology | Group - Multi-Specialty |
| No | 2085B0100X | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NH | 3079022 | Medicaid | |
| NH | CB2727 | Other | RAILROAD MEDICARE |
| NH | RE6119 | Medicare ID - Type Unspecified | MEDICARE GROUP |
| NH | 3079022 | Medicaid |