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General NPI Number Information
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NPI Number | 1396050209
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Entity Type | Organization
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Legal Business Name | NORTH STONINGTON HEALTH CENTER, INC
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Dates
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Enumeration Date | 08/16/2010
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 183 PROVIDENCE NEW LONDON TPKE # E8
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City | NORTH STONINGTON
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State | CT
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Zip | 06359-1721
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Country | US
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Telephone | 860-535-2273
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Fax | 860-535-0204
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Provider Business Mailing Address
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Address Line | 183 PROVIDENCE NEW LONDON TPKE # E8
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City | NORTH STONINGTON
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State | CT
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Zip | 06359-1721
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Country | US
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Telephone | 860-535-2273
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Fax | 860-535-0204
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | MS. JEANNE LACHANCE
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Credential |
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Telephone | 401-348-3711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | CL-0676
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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