Organization
MID-STATE HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM ALBERT SWEENEY JR. MBA (CFO)
(603) 238-3502
Entity
Organization
Contact information
Practice address
607 TENNEY MOUNTAIN HWY STE 144, PLYMOUTH, NH 03264-3156
(603) 536-4000
(603) 536-4001
Mailing address
101 BOULDER POINT DR STE 1, PLYMOUTH, NH 03264-3170
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
301817
MEDICARE FQHC NUMBER
NH
Enumeration date
10/14/2016
Last updated
10/14/2016
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