1215954946 NPI number — WEEKS AND GOWEN PHYSICAL THERAPY ASSOCIATES INC

Table of content: (NPI 1215954946)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215954946 NPI number — WEEKS AND GOWEN PHYSICAL THERAPY ASSOCIATES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEEKS AND GOWEN PHYSICAL THERAPY ASSOCIATES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215954946
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1467
Provider Second Line Business Mailing Address:
23 CARYL LANE
Provider Business Mailing Address City Name:
CHARLESTOWN
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-826-9700
Provider Business Mailing Address Fax Number:
603-826-9703

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23 CARYL LANE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLESTOWN
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-826-9700
Provider Business Practice Location Address Fax Number:
603-826-9703
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GOWEN
Authorized Official First Name:
CLARE
Authorized Official Middle Name:
BARRETT
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
603-826-9700

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1261 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: WEEK18026 . This is a "BCBS" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 63042 . This is a "CIGNA CLARE B GOWEN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 563330 . This is a "US HEALTHCARE GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 626558 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 63040 . This is a "CIGNA GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 80001596 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: H003983 . This is a "CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 18028 . This is a "BCBS" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 563021 . This is a "US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 613627 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".




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