Basic Information
| Provider Information | |||||||||
| NPI: | 1518114305 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MERRIMACK VALLEY HEALTH SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18201 VON KARMAN AVE STE 600 | ||||||||
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| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926121176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9492425300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 323 LOWELL STREET, LL, SUITE 002 | ||||||||
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| City: | NORTH ANDOVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662455995 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2008 | ||||||||
| LastUpdateDate: | 12/30/2019 | ||||||||
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| AuthorizedOfficialLastName: | WILSON | ||||||||
| AuthorizedOfficialFirstName: | DEBORAH | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXEC VP & CFO, INTERIM CEO | ||||||||
| AuthorizedOfficialTelephone: | 9786834000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/30/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No ID Information.