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11 John Stark Hwy Newport NH 03773 | |
(603) 526-5167 | |
(603) 526-5085 |
Full Name | |
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Speciality | Clinic/Center |
Location | 11 John Stark Hwy, Newport, New Hampshire |
Authorized Official Name and Position | Kieran Kays (COMPLIANCE OFFICER) |
Authorized Official Contact | 6035265203 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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11 John Stark Hwy Newport NH 03773 Ph: (603) 526-5167 | 11 John Stark Hwy Newport NH 03773 Ph: (603) 526-5167 |
NPI Number | 1770684672 |
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Provider Enumeration Date | 09/26/2006 |
Last Update Date | 01/21/2021 |
Medicare PECOS PAC ID | 5294643623 |
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Medicare Enrollment ID | O20070510000530 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770684672 | NPI | - | NPPES |
70001001 | Medicaid | NH |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
261QR1300X | Clinic/center - Rural Health | 02132 (New Hampshire) | Secondary |