1255328159 NPI number — THE RIVERWOODS COMPANY AT EXETER, NEW HAMPSHIRE

Table of content: (NPI 1255328159)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255328159 NPI number — THE RIVERWOODS COMPANY AT EXETER, NEW HAMPSHIRE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE RIVERWOODS COMPANY AT EXETER, NEW HAMPSHIRE
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:
RIVERWOODS AT EXETER
Provider Other Organization Name Type Code:
5
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:
1255328159
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 RIVERWOODS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EXETER
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03833-4374
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-742-4700
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7 RIVERWOODS DR
Provider Second Line Business Practice Location Address:
RIVERWOODS AT EXETER
Provider Business Practice Location Address City Name:
EXETER
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03833-4374
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-742-4700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/05/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FLOYD
Authorized Official First Name:
CRYSTAL
Authorized Official Middle Name:
Authorized Official Title or Position:
ACCOUNTING COORDINATOR
Authorized Official Telephone Number:
603-658-1580

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  02112 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LA2200X , with the licence number: 140784 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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