Healthcare Provider Details

I. General information

NPI: 1679648422
Provider Name (Legal Business Name): FRISBIE MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 WHITEHALL RD
ROCHESTER NH
03867-3226
US

IV. Provider business mailing address

32 TIDEVIEW DR
DOVER NH
03820-4578
US

V. Phone/Fax

Practice location:
  • Phone: 603-335-8177
  • Fax: 603-335-8199
Mailing address:
  • Phone: 603-749-4567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number1126
License Number StateNH

VIII. Authorized Official

Name: MS. TRACY ELIZABETH WHITE - GEORGE
Title or Position: CLINICAL SOCIAL WORKER
Credential: LISCW
Phone: 603-330-8973