Provider Demographics
NPI:1275657322
Name:OPTIVAN OF NEWHAMPSHIRE INC
Entity Type:Organization
Organization Name:OPTIVAN OF NEWHAMPSHIRE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:LINNANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-753-9442
Mailing Address - Street 1:217 FISHERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PENACOOK
Mailing Address - State:NH
Mailing Address - Zip Code:03303-2074
Mailing Address - Country:US
Mailing Address - Phone:603-753-9442
Mailing Address - Fax:603-753-6788
Practice Address - Street 1:217 FISHERVILLE RD
Practice Address - Street 2:
Practice Address - City:PENACOOK
Practice Address - State:NH
Practice Address - Zip Code:03303-2074
Practice Address - Country:US
Practice Address - Phone:603-753-9442
Practice Address - Fax:603-753-6788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment