1013069376 NPI number — STRAFFORD HEALTH ALLIANCE

Table of content: (NPI 1013069376)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013069376 NPI number — STRAFFORD HEALTH ALLIANCE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STRAFFORD HEALTH ALLIANCE
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:
1013069376
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/08/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 ROUTE 108
Provider Second Line Business Mailing Address:
SUITE 3
Provider Business Mailing Address City Name:
SOMERSWORTH
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03878-1119
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-742-7492
Provider Business Mailing Address Fax Number:
603-742-6762

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 ROUTE 108
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
SOMERSWORTH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03878-1119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-742-7492
Provider Business Practice Location Address Fax Number:
603-742-6762
Provider Enumeration Date:
01/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BEAUDIN
Authorized Official First Name:
BETH
Authorized Official Middle Name:
Authorized Official Title or Position:
OPERATIONS MANAGER
Authorized Official Telephone Number:
603-742-6673

Provider Taxonomy Codes

  • Taxonomy code: 2471M2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 155010 . This is a "FDA CERTIFICATE #" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com