Provider Demographics
NPI:1316928971
Name:SALEM MEDICAL CENTER
Entity type:Organization
Organization Name:SALEM MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS AND FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-663-4904
Mailing Address - Street 1:4 ORCHARD VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3372
Mailing Address - Country:US
Mailing Address - Phone:603-870-7400
Mailing Address - Fax:603-870-7499
Practice Address - Street 1:4 ORCHARD VIEW DR
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3372
Practice Address - Country:US
Practice Address - Phone:603-870-7400
Practice Address - Fax:603-870-7499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2381513OtherAETNA GROUP #
NH57960OtherCIGNA GROUP #
NHCG2227OtherRR MEDICARE GROUP #
NH30210987Medicaid
NH689017OtherTUFTS GROUP #
NHCG2227OtherRR MEDICARE GROUP #