Basic Information
| Provider Information | |||||||||
| NPI: | 1841875739 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORCHARD MEDICAL GROUP LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 LAKE AVE STE 2 | ||||||||
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| City: | MANCHESTER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031032734 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036210681 | ||||||||
| FaxNumber: | 6032324563 | ||||||||
| Practice Location | |||||||||
| Address1: | 159 N BROADWAY | ||||||||
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| City: | SALEM | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030792136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038934119 | ||||||||
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| ProviderEnumerationDate: | 03/12/2021 | ||||||||
| LastUpdateDate: | 03/12/2021 | ||||||||
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| AuthorizedOfficialLastName: | SILVERNALE | ||||||||
| AuthorizedOfficialFirstName: | MELINDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF RCM | ||||||||
| AuthorizedOfficialTelephone: | 6036210681 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.