Provider Demographics
NPI:1821046061
Name:MERRIMACK VALLEY ORTHOPAEDIC SURGERY
Entity Type:Organization
Organization Name:MERRIMACK VALLEY ORTHOPAEDIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-668-4253
Mailing Address - Street 1:4 ELLIOT WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3547
Mailing Address - Country:US
Mailing Address - Phone:603-625-1655
Mailing Address - Fax:603-626-4686
Practice Address - Street 1:4 ELLIOT WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3547
Practice Address - Country:US
Practice Address - Phone:603-625-1655
Practice Address - Fax:603-626-4686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8097174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH708165OtherTUFTS
NHNAS928OtherHARVARD PILGRIM
NH0066136OtherCIGNA
NV0103992Y0NH01OtherANTHEM
NV0103992Y0NH01OtherANTHEM
NHRE5101Medicare PIN
NHB82453Medicare UPIN