Provider Demographics
NPI:1235131798
Name:MWV HEALTH CARE ASSOC
Entity type:Organization
Organization Name:MWV HEALTH CARE ASSOC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:603-356-0232
Mailing Address - Street 1:PO BOX 2540
Mailing Address - Street 2:
Mailing Address - City:N CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-2540
Mailing Address - Country:US
Mailing Address - Phone:603-356-0232
Mailing Address - Fax:603-356-0275
Practice Address - Street 1:3073 WHITE MOUNTAIN HWY
Practice Address - Street 2:
Practice Address - City:N CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-5111
Practice Address - Country:US
Practice Address - Phone:603-356-0232
Practice Address - Fax:603-356-0275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0515P3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30010294Medicaid
3005851OtherNABP