Provider Demographics
NPI:1881080935
Name:OASIS HEALTH & SPORTS CENTER INC
Entity type:Organization
Organization Name:OASIS HEALTH & SPORTS CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:BENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-624-9300
Mailing Address - Street 1:1 HIGHLANDER WAY
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-7403
Mailing Address - Country:US
Mailing Address - Phone:603-624-9300
Mailing Address - Fax:603-641-6314
Practice Address - Street 1:1 HIGHLANDER WAY
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-7403
Practice Address - Country:US
Practice Address - Phone:603-624-9300
Practice Address - Fax:603-641-6314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0706133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty