Healthcare Provider Details

I. General information

NPI: 1386797066
Provider Name (Legal Business Name): ADVENT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 DERRY RD
HUDSON NH
03051-3049
US

IV. Provider business mailing address

315 DERRY RD
HUDSON NH
03051-3049
US

V. Phone/Fax

Practice location:
  • Phone: 603-595-4466
  • Fax: 603-598-9910
Mailing address:
  • Phone: 603-595-4466
  • Fax: 603-598-9910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberNONE REQUIRED
License Number StateNH

VII. Legacy identifiers

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

# 1
Identifier30009976
Identifier TypeMEDICAID
Identifier StateNH
Identifier Issuer

VIII. Authorized Official

Name: MRS. MICHELLE ADAIR FREIBERGER
Title or Position: MANAGER
Credential: BS RRT
Phone: 603-595-4466