Healthcare Provider Details

I. General information

NPI: 1346418910
Provider Name (Legal Business Name): MONADNOCK BIRTH CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 W. SWANZEY RD
SWANZEY NH
03446
US

IV. Provider business mailing address

907 W. SWANZEY ROAD
SWANZEY NH
03446
US

V. Phone/Fax

Practice location:
  • Phone: 603-352-5860
  • Fax: 802-536-4142
Mailing address:
  • Phone: 603-352-5860
  • Fax: 802-536-4142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number1024
License Number StateNH

VIII. Authorized Official

Name: MS. MARY R. LAWLOR
Title or Position: MIDWIFE
Credential: CPM
Phone: 603-352-5860