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General NPI Number Information
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NPI Number | 1043207566
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Entity Type | Organization
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Legal Business Name | ALICE PECK DAY MEMORIAL HOSPITAL-ECU
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 02/02/2010
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Provider Practice Location Address
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Address Line | 125 MASCOMA ST
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City | LEBANON
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State | NH
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Zip | 03766-2647
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Country | US
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Telephone | 603-448-3121
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Fax | 603-448-7462
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Provider Business Mailing Address
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Address Line | 125 MASCOMA ST
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City | LEBANON
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State | NH
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Zip | 03766-2647
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Country | US
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Telephone | 603-448-3121
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Fax | 603-448-7462
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | HARRY G DORMAN III
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Credential |
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Telephone | 603-448-3121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 0016A
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 0016A
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0016A
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License Number State | NH
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