Healthcare Provider Details

I. General information

NPI: 1730301276
Provider Name (Legal Business Name): BEDFORD SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 COUNTY ROAD
BEDFORD NH
03110-6202
US

IV. Provider business mailing address

103 COUNTY ROAD
BEDFORD NH
03110-6202
US

V. Phone/Fax

Practice location:
  • Phone: 603-472-3755
  • Fax: 603-472-2567
Mailing address:
  • Phone: 603-472-3755
  • Fax: 603-472-2567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateNH

VIII. Authorized Official

Name: MARK CONRAD
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 603-472-3755