Healthcare Provider Details
I. General information
NPI: 1427717800
Provider Name (Legal Business Name): GRANITE STATE UC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/13/2021
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10 FERRY ST STE 302
CONCORD NH
03301-5081
US
IV. Provider business mailing address
10 FERRY ST STE 302
CONCORD NH
03301-5081
US
V. Phone/Fax
- Phone: 603-333-1471
- Fax:
- Phone: 603-333-1471
- Fax: 603-255-7286
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MARCUS
J
HAMPERS
Title or Position: MANAGING EMPLOYEE
Credential: MD
Phone: 603-333-1471