1861475949 NPI number — CITY OF KEENE

Table of content: (NPI 1861475949)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861475949 NPI number — CITY OF KEENE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF KEENE
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:
1861475949
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/29/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 TURCOTTE MEMORIAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROWLEY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01969-1706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-488-4351
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
31 VERNON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KEENE
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03431-3443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-757-1862
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HOWARD
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF - ADMINISTRATOR
Authorized Official Telephone Number:
603-757-1862

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 341600000X , with the licence number: 0057 , 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: 1002974 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: NH6339 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 701322 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 57389 . This is a "VYTRA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 71Y004972NH01 . This is a "ANTHEM BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 590014512 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 353456 . This is a "MVP HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 801885 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 80596339 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: A424939 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".




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