Provider Demographics
NPI:1043257918
Name:HCA HEALTH SERVICES OF NEW HAMPSHIRE INC
Entity type:Organization
Organization Name:HCA HEALTH SERVICES OF NEW HAMPSHIRE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:WIESMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-433-4010
Mailing Address - Street 1:PO BOX 7004
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03802-7004
Mailing Address - Country:US
Mailing Address - Phone:603-436-5110
Mailing Address - Fax:603-433-5245
Practice Address - Street 1:333 BORTHWICK AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7128
Practice Address - Country:US
Practice Address - Phone:603-436-5110
Practice Address - Fax:603-433-5245
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HCA HEALTH SERVICES OF NEW HAMPSHIRE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-01
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
30033031OtherNH PSYCH PORTSMOUTH PAVIL
140140400OtherPORTSMOUTH PAVILION ME P
30S029Medicare Oscar/Certification