| |
700 Lake Ave Ste 2 Manchester NH 03103-2734 | |
(603) 622-3020 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 700 Lake Ave Ste 2, Manchester, New Hampshire |
Authorized Official Name and Position | Claire Gagnon (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 6036213559 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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140 Queen City Ave Manchester NH 03103-7122 Ph: (603) 622-3020 | 700 Lake Ave Ste 2 Manchester NH 03103-2734 Ph: (603) 622-3020 |
NPI Number | 1063912459 |
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Provider Enumeration Date | 02/13/2018 |
Last Update Date | 08/31/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063912459 | NPI | - | NPPES |
3097969 | Medicaid | NH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Healthways Family Practice Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 59 Sheffield Rd, Manchester, NH 03103 Phone: 603-606-7020 Fax: 603-622-4102 |