Organization
MARY HITCHCOCK MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL P. JANTZEN (CHIEF FINANCIAL OFFICER)
(603) 650-5668
Entity
Organization
Contact information
Practice address
ONE MEDICAL CENTER DR, LEBANON, NH 03756-0001
(603) 650-5000
Mailing address
PO BOX 419112, BOSTON, MA 02241-9112
(603) 650-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01799
NH
261QE0002X
Emergency Care Clinic/Center
01799
NH
261QH0700X
Hearing and Speech Clinic/Center
01799
NH
273R00000X
Psychiatric Hospital Unit
01799
NH
282N00000X
General Acute Care Hospital
Primary
01799
NH
332B00000X
Durable Medical Equipment & Medical Supplies
01799
NH
3416A0800X
Air Ambulance
0296
NH
3416A0800X
Air Ambulance
0920
VT
3416L0300X
Land Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0300003
—
VT
05
—
0300900
—
VT
05
—
0RE2206
—
VT
05
—
30005466
—
NH
05
—
30011095
—
NH
05
—
30210001
—
NH
05
—
3076533
—
NH
05
—
80300003
—
NH
05
—
80300900
—
NH
01
—
CD9167
RAILROAD MEDICARE
NH
01
—
DE1531
RAILROAD MEDICARE
VT
Enumeration date
12/02/2005
Last updated
08/12/2021
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