1144223702 NPI number — LITTLETON HOSPITAL ASSOCIATION

Table of content: (NPI 1144223702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144223702 NPI number — LITTLETON HOSPITAL ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LITTLETON HOSPITAL ASSOCIATION
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:
1144223702
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/27/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 160
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
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-444-9000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 ST JOHNSBURY RD
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-444-9395
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/27/2005

Additional Information

Authorized Official

Authorized Official Last Name:
WALKER
Authorized Official First Name:
LESLIE
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OF FINANCE
Authorized Official Telephone Number:
603-444-9505

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X , with the licence number:  02790 , 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: 0300008 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7003625 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100353 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 138260000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0287 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 301302 . This is a "ANTHEM BCBS PROV #" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: OP13013 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0301302 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 54141 . This is a "CIGNA PROVIDER #" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 80300008 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000783 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0285 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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