Healthcare Provider Details

I. General information

NPI: 1013210095
Provider Name (Legal Business Name): SALEM OCCUPATIONAL AND ACUTE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2010
Last Update Date: 12/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 RED ROOF LN STE 2
SALEM NH
03079-2983
US

IV. Provider business mailing address

13 RED ROOF LN STE 2
SALEM NH
03079-2983
US

V. Phone/Fax

Practice location:
  • Phone: 603-898-0961
  • Fax: 603-898-0964
Mailing address:
  • Phone: 603-898-0961
  • Fax: 603-898-0964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number063837-23
License Number StateNH

VIII. Authorized Official

Name: MS. DEANNE CHAPMAN
Title or Position: MEDICAL DIRECTOR
Credential: PA-C
Phone: 603-898-0961