Healthcare Provider Details

I. General information

NPI: 1467436089
Provider Name (Legal Business Name): GOODWIN COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 ROUTE 108
SOMERSWORTH NH
03878-1522
US

IV. Provider business mailing address

311 ROUTE 108
SOMERSWORTH NH
03878-1522
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNH

VIII. Authorized Official

Name: MRS. JANET MARIE ATKINS
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 603-956-0063