Provider Demographics
| NPI: | 1134398100 |
|---|---|
| Name: | BEECHER FALLS CLINIC LLC |
| Entity type: | Organization |
| Organization Name: | BEECHER FALLS CLINIC LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CHIEF EXECUTIVE MANAGER AGENT |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | CLIFFORD |
| Authorized Official - Middle Name: | A |
| Authorized Official - Last Name: | CHAPIN |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 603-237-8482 |
| Mailing Address - Street 1: | 106 RIVER ROAD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BEECHER FALLS |
| Mailing Address - State: | VT |
| Mailing Address - Zip Code: | 05902 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 603-237-8482 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 106 RIVER ROAD |
| Practice Address - Street 2: | |
| Practice Address - City: | BEECHER FALLS |
| Practice Address - State: | VT |
| Practice Address - Zip Code: | 05902 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 603-237-8482 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2008-02-25 |
| Last Update Date: | 2008-02-25 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| NH | 12369 | 207R00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty |