Healthcare Provider Details

I. General information

NPI: 1366421141
Provider Name (Legal Business Name): THE MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 12/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3073 WHITE MOUNTAIN HWY
NORTH CONWAY NH
03860-7101
US

IV. Provider business mailing address

3073 WHITE MOUNTAIN HWY
NORTH CONWAY NH
03860-7101
US

V. Phone/Fax

Practice location:
  • Phone: 603-356-9355
  • Fax: 603-356-8843
Mailing address:
  • Phone: 603-356-9355
  • Fax: 603-356-8843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DIANA MCLAUGHLIN
Title or Position: SENIOR DIRECTOR OF FINANCE
Credential:
Phone: 603-356-0613