Organization
COOS COUNTY FAMILY HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH GORDON CEO (CHIEF EXECUTIVE OFFICER)
(603) 752-3669
Entity
Organization
Contact information
Practice address
133 PLEASANT ST, BERLIN, NH 03570-2006
(603) 752-2040
(603) 752-7797
Mailing address
133 PLEASANT ST, BERLIN, NH 03570-2006
(603) 752-2040
(603) 752-7797
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
NH
207Q00000X
Family Medicine Physician
—
NH
207R00000X
Internal Medicine Physician
—
NH
207V00000X
Obstetrics & Gynecology Physician
—
NH
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
363A00000X
Physician Assistant
—
NH
363LP0200X
Pediatric Nurse Practitioner
—
NH
363LW0102X
Women's Health Nurse Practitioner
—
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30007254
—
NH
05
—
99908646
—
NH
01
—
CN7051
MEDICARE RAILROAD
—
01
—
NH2315
MEDICARE B
NH
Enumeration date
08/12/2005
Last updated
01/10/2018
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