Basic Information
Provider Information
NPI: 1619129053
EntityType: 2
ReplacementNPI:  
OrganizationName: MONADNOCK COMMUNITY HOSPITAL
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: OCCUPATIONAL HEALTH DEPARTMENT
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 452 OLD STREET RD
Address2:  
City: PETERBOROUGH
State: NH
PostalCode: 034581263
CountryCode: US
TelephoneNumber: 6039244699
FaxNumber: 6039244618
Practice Location
Address1: 452 OLD STREET RD
Address2:  
City: PETERBOROUGH
State: NH
PostalCode: 034581263
CountryCode: US
TelephoneNumber: 6039244699
FaxNumber: 6039244618
Other Information
ProviderEnumerationDate: 10/16/2008
LastUpdateDate: 10/16/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SCHEINBLUM
AuthorizedOfficialFirstName: RICHARD
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 6039244699
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2083X0100X0257NHY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine

No ID Information.


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