Healthcare Provider Details

I. General information

NPI: 1508916636
Provider Name (Legal Business Name): GREATER SEACOAST COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 FARMINGTON RD
ROCHESTER NH
03867
US

IV. Provider business mailing address

311 ROUTE 108
SOMERSWORTH NH
03878-1522
US

V. Phone/Fax

Practice location:
  • Phone: 603-335-4522
  • Fax: 603-335-8631
Mailing address:
  • Phone: 603-749-2346
  • Fax: 603-953-0066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY GARCA
Title or Position: BILLING MANAGER
Credential:
Phone: 603-516-2576