Provider Demographics
NPI:1720022163
Name:MERRIMACK VALLEY HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:MERRIMACK VALLEY HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP, GEN. COUNSEL, SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-688-3505
Mailing Address - Street 1:1900 S STATE COLLEGE BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-6136
Mailing Address - Country:US
Mailing Address - Phone:800-544-3215
Mailing Address - Fax:
Practice Address - Street 1:25 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3867
Practice Address - Country:US
Practice Address - Phone:978-463-1295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2020-08-22
Deactivation Date:2006-06-16
Deactivation Code:
Reactivation Date:2010-08-31
Provider Licenses
StateLicense IDTaxonomies
MA4462261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0489237OtherCIGNA / HEALTHSOURCE
MA1532464Medicaid
MA114493500OtherU.S. DEPT OF LABOR OWCP
MA0007697OtherNEIGHBORHOOD HEALTH PLAN
MA708812OtherTUFTS/SECURE HORIZONS
MA608297OtherHARVARD PILGRIM HLTH CARE
MA981083OtherNETWORK HEALTH
MA018269OtherBCBS
MA1532464Medicaid
MA018269OtherBCBS