Healthcare Provider Details

I. General information

NPI: 1720022163
Provider Name (Legal Business Name): MERRIMACK VALLEY HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date: 06/16/2006
Reactivation Date: 08/31/2010

III. Provider practice location address

25 HIGHLAND AVE
NEWBURYPORT MA
01950-3867
US

IV. Provider business mailing address

1900 S STATE COLLEGE BLVD SUITE 600
ANAHEIM CA
92806-6136
US

V. Phone/Fax

Practice location:
  • Phone: 978-463-1295
  • Fax:
Mailing address:
  • Phone: 800-544-3215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number4462
License Number StateMA

VIII. Authorized Official

Name: CHRISTOPHER J. JOYCE
Title or Position: SENIOR VP, GEN. COUNSEL, SECRETARY
Credential:
Phone: 714-688-3505