1649271156 NPI number — ROSS FUNERAL HOME INC

Table of content: (NPI 1649271156)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649271156 NPI number — ROSS FUNERAL HOME INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROSS FUNERAL HOME 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:
ROSS AMBULANCE SERVICE
Provider Other Organization Name Type Code:
3
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:
1649271156
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 632
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLETON
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03561-0632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-444-5377
Provider Business Mailing Address Fax Number:
603-444-6636

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
282 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITTLETON
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03561-3517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-444-5377
Provider Business Practice Location Address Fax Number:
603-444-6636
Provider Enumeration Date:
08/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ROSS-SMITH
Authorized Official First Name:
TAMMY
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CO-OWNER
Authorized Official Telephone Number:
603-444-5377

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  0065 , 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: 10176 . This is a "CIGNA HEALTHSOURCE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30823543 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 801384 . This is a "TUFTS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 700489 . This is a "HARVARD PILGRIM HEALTHCAR" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 87726 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 0005213119 . This is a "AETNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 7106256Y0NH01 . This is a "ANTHEM BCBS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




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