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1023092053

NPI Code Detail

MEDICARE: MARY HITCHCOCK MEMORIAL HOSPITAL

MEDICARE: MARY HITCHCOCK MEMORIAL HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	01799	NH
2	261QE0002X	Emergency Care Clinic/Center	01799	NH
3	261QH0700X	Hearing and Speech Clinic/Center	01799	NH
4	273R00000X	Psychiatric Hospital Unit	01799	NH
5	332B00000X	Durable Medical Equipment & Medical Supplies	01799	NH
6	3416A0800X	Air Ambulance	0296	NH
7	3416A0800X	Air Ambulance	0920	VT
8	3416L0300X	Land Ambulance
9	282N00000X	General Acute Care Hospital	01799	NH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CD9167	OTHER	NH	RAILROAD MEDICARE
9	DE1531	OTHER	VT	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023092053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARY HITCHCOCK MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 419112
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-9112
Country	:	US
Telephone Number	:	603-650-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	ONE MEDICAL CENTER DR
Second Line	:
City	:	LEBANON
State	:	NH
Zip	:	03756-0001
Country	:	US
Telephone Number	:	603-650-5000
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. DANIEL P. JANTZEN
Credential	:
Telephone Number	:	603-650-5668

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	08/12/2021

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Directions to “MARY HITCHCOCK MEMORIAL HOSPITAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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