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General NPI Number Information
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NPI Number | 1922184928
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Entity Type | Organization
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Legal Business Name | LRGHEALTHCARE
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 80 HIGHLAND ST
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City | LACONIA
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State | NH
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Zip | 03246-3235
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Country | US
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Telephone | 603-524-3211
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4144
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City | WOBURN
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State | MA
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Zip | 01888-4144
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Country | US
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Telephone | 603-524-3211
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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 | HENRY D LIPMAN
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Credential | EVP-CFO
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Telephone | 603-524-3211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 00061
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 00061
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 00061
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License Number State | NH
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 00061
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License Number State | NH
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