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General NPI Number Information
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NPI Number | 1891135695
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL HOME HEALTH CARE OF NH, INC
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Dates
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Enumeration Date | 06/26/2013
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 150 NASHUA RD UNIT C
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City | LONDONDERRY
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State | NH
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Zip | 03053-3642
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Country | US
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Telephone | 603-216-9296
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Fax | 603-216-9297
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Provider Business Mailing Address
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Address Line | 150 NASHUA RD UNIT C
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City | LONDONDERRY
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State | NH
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Zip | 03053-3642
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Country | US
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Telephone | 603-216-9296
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Fax | 603-216-9297
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD GARY SULLIVAN
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Credential |
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Telephone | 603-216-9296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 03367
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License Number State | NH
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