Healthcare Provider Details

I. General information

NPI: 1356777825
Provider Name (Legal Business Name): PINEWOOD PROFESSIONALS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 BRIDGE ST
CONCORD NH
03301-4987
US

IV. Provider business mailing address

255 ROUTE 108
SOMERSWORTH NH
03878-1543
US

V. Phone/Fax

Practice location:
  • Phone: 603-415-0090
  • Fax: 603-692-3168
Mailing address:
  • Phone: 603-692-3166
  • Fax: 603-692-3168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE CAUCIS
Title or Position: COO
Credential:
Phone: 603-692-3166