1568421840 NPI number — CAPITAL ORTHOPEDIC SURGERY CENTER

Table of content: (NPI 1568421840)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568421840 NPI number — CAPITAL ORTHOPEDIC SURGERY CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAPITAL ORTHOPEDIC SURGERY CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568421840
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10179
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONCORD
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03301-0179
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-724-2444
Provider Business Mailing Address Fax Number:
603-724-2581

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
116 LANGLEY PARKWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONCORD
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-228-7211
Provider Business Practice Location Address Fax Number:
603-228-7192
Provider Enumeration Date:
03/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
QUINN
Authorized Official First Name:
DONNA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
603-228-7211

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  02816 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 30621577 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 490005259 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 610747700 . This is a "US DEPT OF LABOR" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 699403 . This is a "TUFTS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 18Y002249NH01 . This is a "ANTHEM BLUE CROSS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com