Provider Demographics
NPI:1265212377
Name:COOS COUNTY FAMILY HEALTH SERVICES, INC
Entity type:Organization
Organization Name:COOS COUNTY FAMILY HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHANTAL
Authorized Official - Middle Name:L
Authorized Official - Last Name:HULME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-752-2040
Mailing Address - Street 1:133 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03570-2006
Mailing Address - Country:US
Mailing Address - Phone:603-752-2040
Mailing Address - Fax:
Practice Address - Street 1:141 CORLISS LN
Practice Address - Street 2:
Practice Address - City:COLEBROOK
Practice Address - State:NH
Practice Address - Zip Code:03576-3206
Practice Address - Country:US
Practice Address - Phone:603-237-9195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COOS COUNTY FAMILY HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty