Healthcare Provider Details

I. General information

NPI: 1407331978
Provider Name (Legal Business Name): GREATER SEACOAST COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2018
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 OLD DOVER RD
ROCHESTER NH
03867-3464
US

IV. Provider business mailing address

311 ROUTE 108
SOMERSWORTH NH
03878-1522
US

V. Phone/Fax

Practice location:
  • Phone: 603-561-9300
  • Fax:
Mailing address:
  • Phone: 603-749-2346
  • Fax: 603-953-0066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
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: 603-162-5765