Full Name | |
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Speciality | Clinic/Center |
Location | 17 Market St, Lyme, New Hampshire |
Authorized Official Name and Position | Virginia L Alvord (PHYSICIAN/OWNER) |
Authorized Official Contact | 6039912120 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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17 Market St Lyme NH 03768-3506 Ph: (603) 277-9162 | 17 Market St Lyme NH 03768-3506 Ph: (603) 277-9162 |
NPI Number | 1831677822 |
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Provider Enumeration Date | 08/01/2018 |
Last Update Date | 05/07/2024 |
Medicare PECOS PAC ID | 4082962394 |
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Medicare Enrollment ID | O20180802002373 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831677822 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 9974 (New Hampshire) | Primary |
Provider Name | Virginia L Alvord |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1225012420 PECOS PAC ID: 8224042072 Enrollment ID: I20060131000734 |