1477552602 NPI number — ESSENT HEALTH CARE OF MASS INC

Table of content: (NPI 1477552602)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477552602 NPI number — ESSENT HEALTH CARE OF MASS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ESSENT HEALTH CARE OF MASS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DBA MERRIMACK VALLEY HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477552602
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
140 LINCOLN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAVERHILL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01830-6798
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-521-8137
Provider Business Mailing Address Fax Number:
978-521-8719

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
140 LINCOLN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAVERHILL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01830-6798
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-521-8137
Provider Business Practice Location Address Fax Number:
978-521-8719
Provider Enumeration Date:
07/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HOFFMANN
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
978-521-8137

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  089 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 61088 . This is a "AETNA HEALTH INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000025154 . This is a "BOSTON MEDICAL CENTER HLT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 220174 . This is a "BC BS OF NH (ANTHEM)" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 31530 . This is a "CIGNA HEALTHSOURCE OF MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: WC70669020782 . This is a "ARGONAUT INSURANCE CO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1001302 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1208900 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2222004101 . This is a "BC BS OF MASS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61088 . This is a "CHICKERING CLAIMS ADMIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 903024 . This is a "FIRST SENIORITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61088 . This is a "AETNA US HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3153 . This is a "CIGNA HEALTHSOURCE OF NH" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 5080221 . This is a "EVERCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 903024 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".




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