Healthcare Provider Details

I. General information

NPI: 1740365683
Provider Name (Legal Business Name): SOUTHERN NEW HAMPSHIRE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 NORTHWEST BLVD
NASHUA NH
03063-4068
US

IV. Provider business mailing address

8 PROSPECT ST
NASHUA NH
03060-3925
US

V. Phone/Fax

Practice location:
  • Phone: 603-577-2000
  • Fax:
Mailing address:
  • Phone: 603-577-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number02496
License Number StateNH

VIII. Authorized Official

Name: COLIN T MCHUGH
Title or Position: PRESIDENT/CEO
Credential:
Phone: 603-577-2000