Healthcare Provider Details

I. General information

NPI: 1649757733
Provider Name (Legal Business Name): WENTWORTH-DOUGLASS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2018
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 CORPORATE DR BLDG A
PORTSMOUTH NH
03801-2847
US

IV. Provider business mailing address

PO BOX 412540
BOSTON MA
02241-2540
US

V. Phone/Fax

Practice location:
  • Phone: 603-610-8070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNH

VIII. Authorized Official

Name: JOEL DEGENAARS
Title or Position: EXECUTIVE DIRECTOR OF FINANCE
Credential:
Phone: 603-740-2806