Healthcare Provider Details

I. General information

NPI: 1679405922
Provider Name (Legal Business Name): GRANITE VNA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PILLSBURY ST
CONCORD NH
03301-3502
US

IV. Provider business mailing address

30 PILLSBURY ST
CONCORD NH
03301-3502
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-4093
  • Fax: 603-227-7522
Mailing address:
  • Phone: 603-224-4093
  • Fax: 603-227-7522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: LORI NASH
Title or Position: CORPORATE COMPLIANCE OFFICER
Credential: MSM
Phone: 603-224-4093