1043283831 NPI number — HERRON & SMITH, LLC

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 1043283831 NPI number — HERRON & SMITH, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HERRON & SMITH, LLC
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:
1043283831
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 INDUSTRIAL PARK DR
Provider Second Line Business Mailing Address:
STE. 20
Provider Business Mailing Address City Name:
HOOKSETT
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03106-1805
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-627-8500
Provider Business Mailing Address Fax Number:
603-626-0502

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8 INDUSTRIAL PARK DR
Provider Second Line Business Practice Location Address:
STE. 20
Provider Business Practice Location Address City Name:
HOOKSETT
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03106-1805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-627-8500
Provider Business Practice Location Address Fax Number:
603-626-0502
Provider Enumeration Date:
02/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DUSTIN
Authorized Official First Name:
TAMME
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
603-627-8500

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X , with the licence number:  02877 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X , with the licence number: 02877 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: 02877 , 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: 3078970 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 619864 . This is a "HARVARD PILGRIM PROV. #" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 1043283831 . This is a "CIGNA/CARECENTRIX" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 20381521 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0007482 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7482 . This is a "BC/BS PROVIDER NUMBER" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".




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