Healthcare Provider Details

I. General information

NPI: 1750543013
Provider Name (Legal Business Name): ELLIOT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 HOLT AVE
MANCHESTER NH
03109-5603
US

IV. Provider business mailing address

1 ELLIOT WAY
MANCHESTER NH
03103-3502
US

V. Phone/Fax

Practice location:
  • Phone: 603-663-2448
  • Fax:
Mailing address:
  • Phone: 603-663-2431
  • Fax: 603-663-5820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES OCONNOR
Title or Position: DIR OF PATIENT FINANCIAL SERV
Credential:
Phone: 603-663-2431