Healthcare Provider Details

I. General information

NPI: 1366566028
Provider Name (Legal Business Name): NH VETERANS HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 WINTER ST
TILTON NH
03276-5415
US

IV. Provider business mailing address

139 WINTER ST
TILTON NH
03276-5415
US

V. Phone/Fax

Practice location:
  • Phone: 603-527-4400
  • Fax: 603-527-4402
Mailing address:
  • Phone: 603-527-4400
  • Fax: 603-527-4402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateNH

VIII. Authorized Official

Name: MR. BARRY E. CONWAY
Title or Position: COMMANDANT
Credential:
Phone: 603-427-4400