Basic Information
Provider Information
NPI: 1508819566
EntityType: 2
ReplacementNPI:  
OrganizationName: WEEKS MEDICAL CENTER
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 173 MIDDLE ST
Address2:  
City: LANCASTER
State: NH
PostalCode: 035843508
CountryCode: US
TelephoneNumber: 6037885029
FaxNumber: 6037885607
Practice Location
Address1: 8 CLOVER LANE
Address2:  
City: WHITEFIELD
State: NH
PostalCode: 035983054
CountryCode: US
TelephoneNumber: 6038379005
FaxNumber: 6037885072
Other Information
ProviderEnumerationDate: 05/18/2006
LastUpdateDate: 01/02/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: LEE
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName: D
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 6037885030
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: WEEKS MEDICAL CENTER
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/02/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261Q00000X  Y Ambulatory Health Care FacilitiesClinic/Center 

ID Information
IDTypeStateIssuerDescription
030397605VT MEDICAID
307353105NH MEDICAID
30397601NHANTHEM BC/BSOTHER


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