| Mid-state Health Center | |
|
101 Boulder Point Drive Suite 1 Plymouth NH 03264 | |
| (603) 536-4000 | |
| (603) 536-4001 |
| Full Name | Mid-state Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 101 Boulder Point Drive, Plymouth, New Hampshire |
| Authorized Official Name and Position | Robert Macleod (CEO) |
| Authorized Official Contact | 6035364000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-state Health Center 101 Boulder Point Drive Suite 1 Plymouth NH 03264 Ph: (603) 536-4000 | Mid-state Health Center 101 Boulder Point Drive Suite 1 Plymouth NH 03264 Ph: (603) 536-4000 |
| NPI Number | 1235170549 |
|---|---|
| Provider Enumeration Date | 06/09/2006 |
| Last Update Date | 07/27/2021 |
| Certification Date | 07/27/2021 |
| Medicare PECOS PAC ID | 1951363563 |
|---|---|
| Medicare Enrollment ID | O20060324000344 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235170549 | NPI | - | NPPES |
| 30009302 | Medicaid | NH | |
| 3070979 | Medicaid | NH | |
| 30514289 | Medicaid | NH |
| Provider Name | Tonya F Warren |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316977424 PECOS PAC ID: 7911905401 Enrollment ID: I20090728000565 |
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