Healthcare Provider Details

I. General information

NPI: 1285786061
Provider Name (Legal Business Name): STRAFFORD HEALTH ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 01/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ROUTE 108 SUITE 3
SOMERSWORTH NH
03878-1119
US

IV. Provider business mailing address

200 ROUTE 108 SUITE 3
SOMERSWORTH NH
03878-1119
US

V. Phone/Fax

Practice location:
  • Phone: 603-742-7492
  • Fax: 603-742-6762
Mailing address:
  • Phone: 603-742-7492
  • Fax: 603-742-6762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471B0102X
TaxonomyBone Densitometry Radiologic Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2471M2300X
TaxonomyMammography Radiologic Technologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. BETH BEAUDIN
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 603-742-6673