Healthcare Provider Details

I. General information

NPI: 1548566516
Provider Name (Legal Business Name): CONCORD BIRTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2011
Last Update Date: 02/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 N STATE ST UNIT D
CONCORD NH
03301-3224
US

IV. Provider business mailing address

254 N STATE ST UNIT D
CONCORD NH
03301-3224
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-8710
  • Fax:
Mailing address:
  • Phone: 603-228-8710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number03155
License Number StateNH

VIII. Authorized Official

Name: KATHRYN LEE HARTWELL
Title or Position: OWNER
Credential: CPM, NHCM
Phone: 603-228-8710