Healthcare Provider Details

I. General information

NPI: 1295756476
Provider Name (Legal Business Name): BEDFORD WOMEN'S CARE ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 S RIVER RD SUITE 100
BEDFORD NH
03110-6927
US

IV. Provider business mailing address

160 S RIVER RD SUITE 100
BEDFORD NH
03110-6927
US

V. Phone/Fax

Practice location:
  • Phone: 603-647-0494
  • Fax: 603-647-0493
Mailing address:
  • Phone: 603-647-0494
  • Fax: 603-647-0493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEANNE M JOHNSON
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 603-647-0494