Provider Demographics
NPI:1588861629
Name:UPPER CONNECTICUT VALLEY HOSPITAL
Entity type:Organization
Organization Name:UPPER CONNECTICUT VALLEY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLEERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-237-4971
Mailing Address - Street 1:181 CORLISS LN
Mailing Address - Street 2:
Mailing Address - City:COLEBROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03576-3207
Mailing Address - Country:US
Mailing Address - Phone:603-237-4971
Mailing Address - Fax:603-237-4452
Practice Address - Street 1:181 CORLISS LN
Practice Address - Street 2:
Practice Address - City:COLEBROOK
Practice Address - State:NH
Practice Address - Zip Code:03576-3207
Practice Address - Country:US
Practice Address - Phone:603-237-4971
Practice Address - Fax:603-237-4452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNH0033Medicare ID - Type UnspecifiedMEDICARE PART B