Provider Demographics
NPI:1508413733
Name:MERRIMACK VALLEY HOSPICE, INC.
Entity Type:Organization
Organization Name:MERRIMACK VALLEY HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMES
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA
Authorized Official - Phone:978-552-4000
Mailing Address - Street 1:360 MERRIMACK ST STE 9
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1764
Mailing Address - Country:US
Mailing Address - Phone:978-552-4000
Mailing Address - Fax:
Practice Address - Street 1:178 SAVIN ST STE 300
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-2329
Practice Address - Country:US
Practice Address - Phone:978-552-4159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERRIMACK VALLEY HOSPICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based