Healthcare Provider Details

I. General information

NPI: 1407828247
Provider Name (Legal Business Name): SPRINGFIELD HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 MAIN ST
CHARLESTOWN NH
03603
US

IV. Provider business mailing address

PO BOX 1118
CHARLESTOWN NH
03603
US

V. Phone/Fax

Practice location:
  • Phone: 603-826-5711
  • Fax:
Mailing address:
  • Phone: 603-826-5711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THOMAS CRAWFORD
Title or Position: CEO
Credential:
Phone: 802-885-2151