Healthcare Provider Details

I. General information

NPI: 1972602001
Provider Name (Legal Business Name): EXETER HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 RYE ST
PORTSMOUTH NH
03801-6805
US

IV. Provider business mailing address

PO BOX 5271
MANCHESTER NH
03108-5271
US

V. Phone/Fax

Practice location:
  • Phone: 603-766-8255
  • Fax:
Mailing address:
  • Phone: 603-606-4410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number8794
License Number StateNH

VIII. Authorized Official

Name: MARY PALMER
Title or Position: VICE PRESIDENT
Credential:
Phone: 603-580-7135