Healthcare Provider Details

I. General information

NPI: 1417944778
Provider Name (Legal Business Name): MERRIMACK VALLEY ENDOSCOPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PARKWAY
HAVERHILL MA
01830-6278
US

IV. Provider business mailing address

1 PARKWAY
HAVERHILL MA
01830-6278
US

V. Phone/Fax

Practice location:
  • Phone: 978-521-3235
  • Fax: 978-521-3236
Mailing address:
  • Phone: 978-521-3235
  • Fax: 978-521-3236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY GAINER
Title or Position: PRESIDENT & COO
Credential:
Phone: 857-282-3914