Provider Demographics
NPI:1902996028
Name:ELLIOT HOSPITAL OF THE CITY OF MANCHESTER
Entity Type:Organization
Organization Name:ELLIOT HOSPITAL OF THE CITY OF MANCHESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:CULLEROT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-663-8977
Mailing Address - Street 1:PO BOX 2040
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03105-2040
Mailing Address - Country:US
Mailing Address - Phone:603-663-2431
Mailing Address - Fax:603-663-5820
Practice Address - Street 1:1 ELLIOT WAY
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3502
Practice Address - Country:US
Practice Address - Phone:603-663-2431
Practice Address - Fax:603-663-5820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH00018282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH300012OtherANTHEM BLUE CROSS
NH80300012Medicaid
NHH000556OtherTRICARE
NH900122OtherHARVARD PILGRIM HEALTH PL
NHOTHEROtherMVP HEALTH PLAN
NH904223OtherTUFTS HEALTH PLAN
NHOTHEROtherMVP HEALTH PLAN