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NPI Code Detail

MEDICARE: COOS COUNTY FAMILY HEALTH SERVICES, INC.

MEDICARE: COOS COUNTY FAMILY HEALTH SERVICES, 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
1207Q00000XFamily Medicine PhysicianNH
2207R00000XInternal Medicine PhysicianNH
3363AM0700XMedical Physician AssistantNH
4363LF0000XFamily Nurse PractitionerNH
5208000000XPediatrics PhysicianNH
6261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
35830418OTHERAETNA GROUP
4788438OTHERNHMVP HEALTHCARE

General Provider Information

NPI Number : 1427050012
Entity Type Code : Organization
Provider Name (Legal Business Name) : COOS COUNTY FAMILY HEALTH SERVICES, INC.
Provider Business Mailing Address
First Line : 133 PLEASANT ST
Second Line :
City : BERLIN
State : NH
Zip : 03570-2006
Country : US
Telephone Number : 603-752-2040
Fax Number : 603-752-7797
Provider Business Practice Location Address
First Line : 59 PAGE HILL RD
Second Line :
City : BERLIN
State : NH
Zip : 03570-3531
Country : US
Telephone Number : 603-752-2900
Fax Number : 603-752-3727
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : KENNETH GORDON
Credential : CEO
Telephone Number : 603-752-3669
Provider Enumeration Date : 08/12/2005
Last Update Date : 05/15/2024

Similar Medicare Providers

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1740282680 — THOMAS MEREDITH MD
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1972505733 — ELLEN ROSS PA-C
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1588666267 — KEITH SHUTE MD
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59 PAGE HILL RD
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1801889761 — MAHLON ARTHUR BRADLEY MD
Practice Location Address:
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1295729507 — BEATRICE CLAUDIA ENGSTRAND MD
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03570-3531
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Directions to “COOS COUNTY FAMILY HEALTH SERVICES, INC. ” Practice Location

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