Healthcare Provider Details

I. General information

NPI: 1114237187
Provider Name (Legal Business Name): SPEARE MEMORIAL HOSP PHCY DEPT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 HOSPITAL RD
PLYMOUTH NH
03264-1126
US

IV. Provider business mailing address

16 HOSPITAL RD
PLYMOUTH NH
03264-1126
US

V. Phone/Fax

Practice location:
  • Phone: 603-238-2226
  • Fax: 603-238-6419
Mailing address:
  • Phone: 603-238-2226
  • Fax: 603-238-6419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number0057
License Number StateNH

VIII. Authorized Official

Name: CRYSTAL CASCUDDEN
Title or Position: PHARMACY DIRECTOR
Credential: RPH
Phone: 603-238-2226