Healthcare Provider Details

I. General information

NPI: 1720026511
Provider Name (Legal Business Name): VISITING NURSE HOME CARE & HOSPICE OF CARROLL COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 09/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1529 WHITE MOUNTAIN HIGHWAY
NORTH CONWAY NH
03860-5355
US

IV. Provider business mailing address

PO BOX 432
NORTH CONWAY NH
03860-0432
US

V. Phone/Fax

Practice location:
  • Phone: 603-356-7006
  • Fax: 603-356-8134
Mailing address:
  • Phone: 603-356-7006
  • Fax: 603-356-8134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number02737
License Number StateNH

VIII. Authorized Official

Name: MS. KATHY A FLAHERTY
Title or Position: HOSPICE ADMINISTRATOR
Credential: R.N.
Phone: 603-356-7006