Healthcare Provider Details

I. General information

NPI: 1033344502
Provider Name (Legal Business Name): UPPER CONNECTICUT VALLEY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2009
Last Update Date: 05/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 CORLISS LN
COLEBROOK NH
03576-3207
US

IV. Provider business mailing address

181 CORLISS LN
COLEBROOK NH
03576-3207
US

V. Phone/Fax

Practice location:
  • Phone: 603-237-4971
  • Fax:
Mailing address:
  • Phone: 603-237-4971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: PAMELA G FRIZZELL
Title or Position: CONTROLLER
Credential:
Phone: 603-388-4242