Healthcare Provider Details

I. General information

NPI: 1841548054
Provider Name (Legal Business Name): LRGHEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2012
Last Update Date: 08/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 HIGHLAND ST
LACONIA NH
03246-3235
US

IV. Provider business mailing address

PO BOX 678
LACONIA NH
03247-0678
US

V. Phone/Fax

Practice location:
  • Phone: 603-524-3211
  • Fax:
Mailing address:
  • Phone: 603-524-3211
  • Fax: 603-527-7164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HENRY D LIPMAN
Title or Position: SR VICE PRESIDENT, FINANCIAL STRATE
Credential:
Phone: 603-527-2802