Healthcare Provider Details

I. General information

NPI: 1033736517
Provider Name (Legal Business Name): LAMPREY HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2020
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 QUINCY ST
NASHUA NH
03060-3417
US

IV. Provider business mailing address

207 S MAIN ST
NEWMARKET NH
03857-1835
US

V. Phone/Fax

Practice location:
  • Phone: 603-292-7292
  • Fax:
Mailing address:
  • Phone: 603-659-3106
  • Fax: 603-659-8003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: GREG WHITE
Title or Position: CEO
Credential:
Phone: 603-922-7214