Organization
TOWN OF PLYMOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASINO CLOGSTON (CHIEF)
(603) 536-1253
Entity
Organization
Contact information
Practice address
42 HIGHLAND ST, PLYMOUTH, NH 03264-1236
(603) 536-1253
Mailing address
42 HIGHLAND ST, PLYMOUTH, NH 03264-1236
(603) 536-1253
(603) 536-0035
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
590008029
RR MEDICARE
—
01
—
700353
HARVARD PILGRIM
—
01
—
7106290Y0NH01
BLUE CROSS BLUE SHIELD
—
01
—
734851
TUFTS HEALTH PLAN
—
05
—
80006290
—
NH
Enumeration date
01/04/2006
Last updated
10/01/2015
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