Provider Demographics
NPI:1881635837
Name:MERRIMACK EMERGENCY PHYSICIANS
Entity Type:Organization
Organization Name:MERRIMACK EMERGENCY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:BAXTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-663-2830
Mailing Address - Street 1:1 ELLIOT WAY
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3502
Mailing Address - Country:US
Mailing Address - Phone:603-663-2830
Mailing Address - Fax:603-663-1849
Practice Address - Street 1:1 ELLIOT WAY
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3502
Practice Address - Country:US
Practice Address - Phone:603-663-2830
Practice Address - Fax:603-663-1849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH67686OtherGROUP CIGNA
NH30212549Medicaid
NH697851OtherGROUP TUFTS
NHMERR99465OtherGROUP ANTHEM BCBS
NHMERR99465OtherGROUP ANTHEM BCBS