Provider Demographics
NPI:1366432858
Name:EXETER HEALTHCARE,INC
Entity type:Organization
Organization Name:EXETER HEALTHCARE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-580-7151
Mailing Address - Street 1:4 ALUMNI DR
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2118
Mailing Address - Country:US
Mailing Address - Phone:603-778-1668
Mailing Address - Fax:603-778-2829
Practice Address - Street 1:4 ALUMNI DR
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2118
Practice Address - Country:US
Practice Address - Phone:603-778-1668
Practice Address - Fax:603-778-2829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02201314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80305019Medicaid
NH0988420001Medicare NSC
NH305019Medicare ID - Type Unspecified
NH80305019Medicaid