| County Of Grafton | |
|
3855 Dartmouth College Hwy North Haverhill NH 03774-4909 | |
| (603) 787-6971 | |
| (603) 787-2035 |
| Full Name | County Of Grafton |
|---|---|
| Speciality | Skilled Nursing Facility |
| Location | 3855 Dartmouth College Hwy, North Haverhill, New Hampshire |
| Authorized Official Name and Position | Dawn L Jurentkuff (CFO) |
| Authorized Official Contact | 6037876971 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| County Of Grafton 3855 Dartmouth College Hwy North Haverhill NH 03774-4909 Ph: (603) 787-6971 | County Of Grafton 3855 Dartmouth College Hwy North Haverhill NH 03774-4909 Ph: (603) 787-6971 |
| NPI Number | 1053319517 |
|---|---|
| Provider Enumeration Date | 07/08/2005 |
| Last Update Date | 11/01/2019 |
| Medicare PECOS PAC ID | 8921058553 |
|---|---|
| Medicare Enrollment ID | O20050131000880 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053319517 | NPI | - | NPPES |
| 99750025 | Medicaid | NH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 1053319517 (New Hampshire) | Secondary |
| 314000000X | Skilled Nursing Facility | 00214 (New Hampshire) | Primary |
| Provider Name | Lili O Cargill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417906496 PECOS PAC ID: 4082657549 Enrollment ID: I20050606000661 |