Provider Demographics
NPI:1245291350
Name:ELLIOT 1 DAY SURGERY CENTER
Entity type:Organization
Organization Name:ELLIOT 1 DAY SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIMEAU
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA
Authorized Official - Phone:603-663-3580
Mailing Address - Street 1:185 QUEEN CITY AVENUE
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101
Mailing Address - Country:US
Mailing Address - Phone:603-663-3000
Mailing Address - Fax:603-626-4300
Practice Address - Street 1:185 QUEEN CITY AVENUE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101
Practice Address - Country:US
Practice Address - Phone:603-663-3000
Practice Address - Fax:603-626-4300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02840261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80301002Medicaid
NH301002Medicare PIN