Basic Information
| Provider Information | |||||||||
| NPI: | 1508916636 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GREATER SEACOAST COMMUNITY HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 311 ROUTE 108 | ||||||||
| Address2: | |||||||||
| City: | SOMERSWORTH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038781522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037492346 | ||||||||
| FaxNumber: | 6039530066 | ||||||||
| Practice Location | |||||||||
| Address1: | 180 FARMINGTON RD | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03867 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6033354522 | ||||||||
| FaxNumber: | 6033358631 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2007 | ||||||||
| LastUpdateDate: | 08/16/2018 | ||||||||
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| AuthorizedOfficialLastName: | GARCA | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6035162576 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | N | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | 261QF0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
ID Information
| ID | Type | State | Issuer | Description | 1508916636 | 01 | NH | GROUP NPI | OTHER |