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NPI Code Detail

MEDICARE: MERRIMACK VALLEY PAIN MANAGEMENT ASSOCIATES, P.C.

MEDICARE: MERRIMACK VALLEY PAIN MANAGEMENT ASSOCIATES, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP3300XPain Clinic/Center213741MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11962652990OTHERMATRICARE
2614350100OTHERMATUFTS
3614350100OTHERMAACS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5AA132832OTHERMAHEALTHCARE VALUE
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7AA132832OTHERMAHEALTH PLANS
8M19676OTHERMABC/BS
9AA132832OTHERMAHARVARD
101881694180OTHERMABMC
111881694180OTHERMAFALLON
121962652990OTHERMAGIC UNICARE
139111315OTHERMAAETNA

General Provider Information

NPI Number : 1962652990
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERRIMACK VALLEY PAIN MANAGEMENT ASSOCIATES, P.C.
Provider Business Mailing Address
First Line : 280 MERRIMACK ST STE 103
Second Line :
City : LAWRENCE
State : MA
Zip : 01843-1780
Country : US
Telephone Number : 978-685-2455
Fax Number : 978-685-2459
Provider Business Practice Location Address
First Line : 280 MERRIMACK ST STE 103
Second Line :
City : LAWRENCE
State : MA
Zip : 01843-1780
Country : US
Telephone Number : 978-685-2455
Fax Number : 978-685-2459
Authorized Official
Title or Position : PRESIDENT
Name : DR. RAMI RUSTUM
Credential : MD
Telephone Number : 978-685-2455
Provider Enumeration Date : 09/26/2008
Last Update Date : 01/31/2018

Similar Medicare Providers

1992655625 — REBEKAH J DARRIGO
Practice Location Address:
280 MERRIMACK ST STE 201
LAWRENCE, MA
01843-1780
Practice Phone: 978-557-2632
Practice Fax:
1336090349 — JESSICA CATHERINE GRIGGS MSW
Practice Location Address:
280 MERRIMACK ST STE 141
LAWRENCE, MA
01843-1780
Practice Phone: 978-267-5066
Practice Fax:
1295013191 — NEW ENGLAND PRIMARY CARE ASSOCIATES P.C.
Practice Location Address:
280 MERRIMACK ST STE 103
LAWRENCE, MA
01843-1780
Practice Phone: 978-685-2455
Practice Fax: 978-685-2459
1720363534 — MRS. CHRISTINA ZINNA MEADE PMHNP
Practice Location Address:
280 MERRIMACK ST STE 141
LAWRENCE, MA
01843-1780
Practice Phone: 508-901-4686
Practice Fax:
1194355578 — JOHN THAGARD
Practice Location Address:
280 MERRIMACK ST STE 141
LAWRENCE, MA
01843-1780
Practice Phone: 508-901-2044
Practice Fax:
1790356434 — REGINA MACHARIA
Practice Location Address:
280 MERRIMACK ST STE 141
LAWRENCE, MA
01843-1780
Practice Phone: 508-475-9711
Practice Fax:

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