Healthcare Provider Details
I. General information
NPI: 1891120812
Provider Name (Legal Business Name): BIO-MEDICAL APPLICATIONS OF NEW HAMPSHIRE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/10/2013
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19 KEEWAYDIN DR STE A
SALEM NH
03079-4891
US
IV. Provider business mailing address
19 KEEWAYDIN DR STE A
SALEM NH
03079-4891
US
V. Phone/Fax
- Phone: 603-870-0969
- Fax: 603-870-0987
- Phone: 603-870-0969
- Fax: 603-870-0987
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QE0700X |
| Taxonomy | End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| License Number | |
| License Number State | NH |
VIII. Authorized Official
Name:
BARRY
L.
BLANTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 781-699-9000