Provider Demographics
NPI:1861568743
Name:ANDROSCOGGIN VALLEY HOSPITAL, INC.
Entity type:Organization
Organization Name:ANDROSCOGGIN VALLEY HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:DESMOND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:603-326-5867
Mailing Address - Street 1:59 PAGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03570-3531
Mailing Address - Country:US
Mailing Address - Phone:603-326-5867
Mailing Address - Fax:
Practice Address - Street 1:59 PAGE HILL RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NH
Practice Address - Zip Code:03570-3531
Practice Address - Country:US
Practice Address - Phone:603-326-5867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH00050282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access