Provider Demographics
NPI:1215148069
Name:CHPG DBA CHOLESTEROL TREATMENT CENTER
Entity type:Organization
Organization Name:CHPG DBA CHOLESTEROL TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN SERVICES COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FALKENHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-227-7140
Mailing Address - Street 1:246 PLEASANT ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2548
Mailing Address - Country:US
Mailing Address - Phone:603-230-1920
Mailing Address - Fax:603-230-1922
Practice Address - Street 1:246 PLEASANT ST
Practice Address - Street 2:SUITE 210
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2548
Practice Address - Country:US
Practice Address - Phone:603-230-1920
Practice Address - Fax:603-230-1922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE3988Medicare ID - Type Unspecified