MEDICARE: NORTH COUNTRY HOME HEALTH & HOSPICE AGENCY, INC

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	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1134734825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH COUNTRY HOME HEALTH & HOSPICE AGENCY, INC

Provider Business Mailing Address
First Line	:	536 COTTAGE ST
Second Line	:
City	:	LITTLETON
State	:	NH
Zip	:	03561-4120
Country	:	US
Telephone Number	:	603-444-5317
Fax Number	:

Provider Business Practice Location Address
First Line	:	536 COTTAGE ST
Second Line	:
City	:	LITTLETON
State	:	NH
Zip	:	03561-4120
Country	:	US
Telephone Number	:	603-444-5317
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL COUNTER
Credential	:
Telephone Number	:	603-444-5317

Provider Enumeration Date	:	09/10/2020
Last Update Date	:	09/10/2020

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