| Mascoma Community Healthcare Inc | |
|
18 Roberts Road Canaan NH 03741 | |
| (603) 523-4501 | |
| Not Available |
| Full Name | Mascoma Community Healthcare Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 18 Roberts Road, Canaan, New Hampshire |
| Authorized Official Name and Position | Michael Samson (FINANCE MANAGER) |
| Authorized Official Contact | 6035234501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mascoma Community Healthcare Inc Po Box 550 Canaan NH 03741-0550 Ph: (603) 523-4501 | Mascoma Community Healthcare Inc 18 Roberts Road Canaan NH 03741 Ph: (603) 523-4501 |
| NPI Number | 1497298087 |
|---|---|
| Provider Enumeration Date | 11/30/2016 |
| Last Update Date | 03/08/2024 |
| Medicare PECOS PAC ID | 2466736525 |
|---|---|
| Medicare Enrollment ID | O20170309000707 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497298087 | NPI | - | NPPES |
| Provider Name | Carrie M Webber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245372721 PECOS PAC ID: 8022039882 Enrollment ID: I20051208000713 |
| Provider Name | Ellis B Gardner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932130630 PECOS PAC ID: 2163706227 Enrollment ID: I20170309000863 |
| Provider Name | Frederick K Wiese |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194739672 PECOS PAC ID: 0547340853 Enrollment ID: I20190410002560 |
| Provider Name | Isabel D Watts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073122297 PECOS PAC ID: 0749698207 Enrollment ID: I20210421002140 |
| Provider Name | Rachel M Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407586969 PECOS PAC ID: 4183007909 Enrollment ID: I20220811001726 |
| Provider Name | Mona Elzarka |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1144454760 PECOS PAC ID: 0941746374 Enrollment ID: I20240722003746 |
| Provider Name | Kristen Taylor Gallub |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1679260798 PECOS PAC ID: 6305372459 Enrollment ID: I20241212000906 |
| Provider Name | Morgan Ritchie |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1346926607 PECOS PAC ID: 7315309143 Enrollment ID: I20250108004211 |
| Provider Name | Thomas Duplinsky |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1649319708 PECOS PAC ID: 1557515814 Enrollment ID: I20250109000738 |