Provider Demographics
NPI:1134240195
Name:NORTH COUNTRY HEALTH CONSORTIUM
Entity type:Organization
Organization Name:NORTH COUNTRY HEALTH CONSORTIUM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-259-3700
Mailing Address - Street 1:262 COTTAGE ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-4146
Mailing Address - Country:US
Mailing Address - Phone:603-259-3700
Mailing Address - Fax:603-444-0945
Practice Address - Street 1:262 COTTAGE ST
Practice Address - Street 2:SUITE 230
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-4146
Practice Address - Country:US
Practice Address - Phone:603-259-3700
Practice Address - Fax:603-444-0945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3071347Medicaid