MEDICARE: 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	313M00000X	Nursing Facility/Intermediate Care Facility	NH0009A	NH

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

General Provider Information

NPI Number	:	1871580811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	3073 WHITE MOUNTAIN HWY
Second Line	:
City	:	NORTH CONWAY
State	:	NH
Zip	:	03860-7101
Country	:	US
Telephone Number	:	603-356-5461
Fax Number	:

Provider Business Practice Location Address
First Line	:	3073 WHITE MOUNTAIN HWY
Second Line	:
City	:	NORTH CONWAY
State	:	NH
Zip	:	03860-5111
Country	:	US
Telephone Number	:	603-356-5461
Fax Number	:	603-356-6033

Authorized Official
Title or Position	:	EXECUTIVE ASSISTANT
Name	:	DIANA J MCLAUGHLIN
Credential	:
Telephone Number	:	603-356-0613

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	05/11/2022

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Directions to “MEMORIAL HOSPITAL ” Practice Location

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