Provider Demographics
NPI:1609172055
Name:MERRIMACK VALLEY HOSPITAL, A STEWARD FAMILY HOSPITAL, INC.
Entity Type:Organization
Organization Name:MERRIMACK VALLEY HOSPITAL, A STEWARD FAMILY HOSPITAL, INC.
Other - Org Name:MERRIMACK VALLEY HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:EVP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-419-4709
Mailing Address - Street 1:140 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6700
Practice Address - Country:US
Practice Address - Phone:978-374-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEWARD HEALTH CARE SYSTEM LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-02
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA22S174Medicare Oscar/Certification