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General NPI Number Information
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NPI Number | 1023092053
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Entity Type | Organization
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Legal Business Name | MARY HITCHCOCK MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | ONE MEDICAL CENTER DR
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City | LEBANON
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State | NH
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Zip | 03756-0001
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Country | US
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Telephone | 603-650-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 419112
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City | BOSTON
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State | MA
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Zip | 02241-9112
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Country | US
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Telephone | 603-650-5000
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. DANIEL P. JANTZEN
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Credential |
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Telephone | 603-650-5668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01799
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | 01799
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 01799
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License Number State | NH
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Taxonomy #4
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 01799
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License Number State | NH
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Taxonomy #5
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 01799
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License Number State | NH
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Taxonomy #6
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Taxonomy Code | 3416A0800X
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Taxonomy Name | Air Ambulance
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License Number | 0296
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License Number State | NH
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Taxonomy #7
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Taxonomy Code | 3416A0800X
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Taxonomy Name | Air Ambulance
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License Number | 0920
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License Number State | VT
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Taxonomy #8
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 01799
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License Number State | NH
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