Healthcare Provider Details

I. General information

NPI: 1801359302
Provider Name (Legal Business Name): ANDROSCOGGIN VALLEY HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 PAGE HILL RD
BERLIN NH
03570-3531
US

IV. Provider business mailing address

59 PAGE HILL RD
BERLIN NH
03570-3531
US

V. Phone/Fax

Practice location:
  • Phone: 603-752-2300
  • Fax:
Mailing address:
  • Phone: 603-752-2200
  • Fax: 603-752-1836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SUZANNE L LANDRY
Title or Position: AVH SR. DIRECTOR, MED STAFF OFFICE
Credential: CPCO
Phone: 603-326-5608