County Of Grafton | |
3855 Dartmouth College Hwy North Haverhill NH 03774-4909 | |
(603) 787-6971 | |
(603) 787-2035 |
Full Name | County Of Grafton |
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Speciality | Skilled Nursing Facility |
Location | 3855 Dartmouth College Hwy, North Haverhill, New Hampshire |
Authorized Official Name and Position | Dawn L Jurentkuff (CFO) |
Authorized Official Contact | 6037876971 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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County Of Grafton 3855 Dartmouth College Hwy North Haverhill NH 03774-4909 Ph: (603) 787-6971 | County Of Grafton 3855 Dartmouth College Hwy North Haverhill NH 03774-4909 Ph: (603) 787-6971 |
NPI Number | 1053319517 |
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Provider Enumeration Date | 07/08/2005 |
Last Update Date | 11/01/2019 |
Medicare PECOS PAC ID | 8921058553 |
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Medicare Enrollment ID | O20050131000880 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053319517 | NPI | - | NPPES |
99750025 | Medicaid | NH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 1053319517 (New Hampshire) | Secondary |
314000000X | Skilled Nursing Facility | 00214 (New Hampshire) | Primary |
Provider Name | Lili O Cargill |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417906496 PECOS PAC ID: 4082657549 Enrollment ID: I20050606000661 |