Healthcare Provider Details

I. General information

NPI: 1124170808
Provider Name (Legal Business Name): GERIATRIC AND HOSPICE MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 THE FLUME
AMHERST NH
03031-1520
US

IV. Provider business mailing address

28 THE FLUME
AMHERST NH
03031-1520
US

V. Phone/Fax

Practice location:
  • Phone: 281-358-7766
  • Fax: 281-605-1451
Mailing address:
  • Phone: 281-358-7766
  • Fax: 281-605-1451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA ASHLEY DEVRIES
Title or Position: OWNER
Credential: PA-C
Phone: 281-358-7766