Provider Demographics
NPI:1346418910
Name:MONADNOCK BIRTH CENTER, LLC
Entity type:Organization
Organization Name:MONADNOCK BIRTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:R
Authorized Official - Last Name:LAWLOR
Authorized Official - Suffix:
Authorized Official - Credentials:CPM
Authorized Official - Phone:603-352-5860
Mailing Address - Street 1:907 W. SWANZEY ROAD
Mailing Address - Street 2:
Mailing Address - City:SWANZEY
Mailing Address - State:NH
Mailing Address - Zip Code:03446
Mailing Address - Country:US
Mailing Address - Phone:603-352-5860
Mailing Address - Fax:802-536-4142
Practice Address - Street 1:907 W. SWANZEY RD
Practice Address - Street 2:
Practice Address - City:SWANZEY
Practice Address - State:NH
Practice Address - Zip Code:03446
Practice Address - Country:US
Practice Address - Phone:603-352-5860
Practice Address - Fax:802-536-4142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1024261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009329Medicaid