Healthcare Provider Details

I. General information

NPI: 1841048436
Provider Name (Legal Business Name): MARY HITCHCOCK MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 QUALITY DR
HOOKSETT NH
03106-2625
US

IV. Provider business mailing address

1000 QUALITY DR
HOOKSETT NH
03106-2625
US

V. Phone/Fax

Practice location:
  • Phone: 603-653-3785
  • Fax:
Mailing address:
  • Phone: 603-653-3785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: PATRICK F. JORDAN
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 603-650-5706