NPIMap

Organization Active NPI

Elliot Hospital of the City of Manchester

  • Durable Medical Equipment & Medical Supplies
  • Manchester, NH
National Provider Identifier
1689764482
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
00018 Issued in NH
Legal business name
ELLIOT HOSPITAL OF THE CITY OF MANCHESTER
Practice address
1050 Holt Ave
Suite 5
Manchester, NH 03109-5615
Phone
(603) 663-2728
Fax
(603) 663-5820
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Marc G Cullerot
Title
Vice President of Finance
Phone
(603) 663-8977

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 00018 NH Primary

Addresses

Primary practice location

1050 Holt Ave
Suite 5
Manchester, NH 03109-5615

Mailing address

1070 Holt Ave
Suite 2100
Manchester, NH 03109-5603
Phone (603) 663-2728

Other identifiers 3

IdentifierTypeStateIssuer
1207512Y0NH01OtherNHANTHEM BC DME
2609052Y0NH01OtherNHANTHEM BC IV
80002306MedicaidNH

Other names 1

  • Home Medical Equipment and IV Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930089668 NH DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 3173434982 Practice locations: Manchester, NH

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Elliot Adult Day Care10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

140 Tarrytown Rd
Manchester, NH 03103
Phone (603) 663-4430

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409184000000",
    "number": "1689764482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 HOLT AVE",
            "address_2": "SUITE 2100",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031095603",
            "telephone_number": "603-663-2728",
            "fax_number": "603-663-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 HOLT AVE",
            "address_2": "SUITE 5",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031095615",
            "telephone_number": "603-663-2728",
            "fax_number": "603-663-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOT HOSPITAL OF THE CITY OF MANCHESTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2014-08-28",
        "status": "A",
        "authorized_official_last_name": "CULLEROT",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "603-663-8977",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NH",
            "license": "00018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC DME",
            "identifier": "1207512Y0NH01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC IV",
            "identifier": "2609052Y0NH01",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80002306",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Medical Equipment and IV Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.