Healthcare Provider Details

I. General information

NPI: 1902900129
Provider Name (Legal Business Name): CATHOLIC MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MCGREGOR ST
MANCHESTER NH
03102-3730
US

IV. Provider business mailing address

100 MCGREGOR ST
MANCHESTER NH
03102-3730
US

V. Phone/Fax

Practice location:
  • Phone: 603-668-3545
  • Fax: 603-663-8757
Mailing address:
  • Phone: 603-668-3545
  • Fax: 603-663-8757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number00646
License Number StateNH

VIII. Authorized Official

Name: MR. ANDRE THERRIEN
Title or Position: CONTROLLER
Credential:
Phone: 603-663-8779