1366445090 NPI number — COUNTY OF CHESHIRE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366445090 NPI number — COUNTY OF CHESHIRE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF CHESHIRE
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:
6
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:
1366445090
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12 COURT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KEENE
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03431-3402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-355-0154
Provider Business Mailing Address Fax Number:
603-355-3000

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 RIVER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTMORELAND
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03467-4410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-399-4219
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/27/2005

Additional Information

Authorized Official

Authorized Official Last Name:
TROMBLY
Authorized Official First Name:
SHERYL
Authorized Official Middle Name:
Authorized Official Title or Position:
FINANCE DIRECTOR
Authorized Official Telephone Number:
603-355-3036

Provider Taxonomy Codes

  • Taxonomy code: 313M00000X , with the licence number:  00084 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , with the licence number: 00084 , 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: 30010973 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30010206 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 80848085 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30590545 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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