Organization
CATHOLIC MEDICAL CENTER
Active
Other names
Health Care for the Homeless Program
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD DUDLEY (CFO)
(603) 663-6180
Entity
Organization
Contact information
Practice address
177 LAKE AVE, MANCHESTER, NH 03103-5321
(603) 782-7414
(603) 518-8707
Mailing address
195 MCGREGOR ST, SUITE LL22, MANCHESTER, NH 03102-3748
(603) 663-8701
(603) 663-8766
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30518396
—
NH
Enumeration date
06/07/2011
Last updated
10/23/2020
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