Healthcare Provider Details

I. General information

NPI: 1114266202
Provider Name (Legal Business Name): WENTWORTH-DOUGLASS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2013
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 CENTRAL AVENUE
DOVER NH
03820
US

IV. Provider business mailing address

789 CENTRAL AVE
DOVER NH
03820-2526
US

V. Phone/Fax

Practice location:
  • Phone: 603-742-5252
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number0093
License Number StateNH

VIII. Authorized Official

Name: JOEL DEGENAARS
Title or Position: EXECUTIVE DIRECTOR OF FINANCE
Credential:
Phone: 603-740-2806