Healthcare Provider Details
I. General information
NPI: 1568459931
Provider Name (Legal Business Name): HUGGINS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/30/2005
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
240 S MAIN ST MEDICAL ARTS BUILDING, SUITE A
WOLFEBORO NH
03894-4411
US
IV. Provider business mailing address
240 S MAIN ST
WOLFEBORO NH
03894-4411
US
V. Phone/Fax
- Phone: 603-569-7574
- Fax: 603-569-7582
- Phone: 603-569-7574
- Fax: 603-569-7582
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JEREMY
S
ROBERGE
Title or Position: PRESIDENT & CEO
Credential:
Phone: 603-569-7510