Healthcare Provider Details

I. General information

NPI: 1134240195
Provider Name (Legal Business Name): NORTH COUNTRY HEALTH CONSORTIUM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 03/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 COTTAGE ST SUITE 230
LITTLETON NH
03561-4146
US

IV. Provider business mailing address

262 COTTAGE ST SUITE 230
LITTLETON NH
03561-4146
US

V. Phone/Fax

Practice location:
  • Phone: 603-259-3700
  • Fax: 603-444-0945
Mailing address:
  • Phone: 603-259-3700
  • Fax: 603-444-0945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: NANCY FRANK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 603-259-3700