Healthcare Provider Details

I. General information

NPI: 1366971186
Provider Name (Legal Business Name): MARY HITCHCOCK MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 ROPE FERRY RD
HANOVER NH
03755-1421
US

IV. Provider business mailing address

5 ROPE FERRY RD HINMAN BOX 6143
HANOVER NH
03755-1421
US

V. Phone/Fax

Practice location:
  • Phone: 603-646-9456
  • Fax: 603-646-9447
Mailing address:
  • Phone: 603-646-9456
  • Fax: 603-646-9447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0814
License Number StateNH

VIII. Authorized Official

Name: KEITH B THOMASSET
Title or Position: CHIEF PHARMACY OFFICER
Credential:
Phone: 781-760-4849