Merrimack River Medical Services, Inc.
Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Lewiston, ME
NPI 1740573161 · NPPES record last updated Jul 29, 2024
Key facts
- NPI
- 1740573161
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
- Legal business name
- MERRIMACK RIVER MEDICAL SERVICES, INC.
- Practice address
- 18 Mollison Way
Lewiston, ME 04240-5811 - Phone
- (413) 568-6600
- Fax
- (413) 562-8360
- NPI assigned
- May 18, 2011
- Organization subpart
- No
Authorized official
- Name
- Bruce Jarvie
- Title
- VP, Treasurer
- Phone
- (214) 379-3300
Other NPIs on the same Medicare enrollment 2
Practitioners 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 20D2131840 | Merrimack River Medical Services, Inc | Certificate of waiver | Jun 6, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
- Opioid treatment program
- Medicare-enrolled since Jan 1, 2020
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200505000935 | NH | Part B Supplier - Opioid Treatment Program (Otp) | 1850676354 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hudson, NH; Newington, NH; Somersworth, NH |
National Provider Directory
Locations
18 Mollison Way
Lewiston, ME 04240
Phone (207) 312-6860
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Methadone Clinic | 261QM2800X | |||
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | Yes |
Addresses
Primary practice location
18 Mollison Way
Lewiston, ME 04240-5811
Mailing address
1720 Lakepointe Dr
Lewisville, TX 75057-6458
Phone (214) 379-3300
Other names
- Health Care Resource Centers
Other providers in Lewiston, ME
- Sarah A Meltzer
- Mercy Care Residential (MCR(
- Anne Melissa Merrick
- Bethany Merrill
- Chad Daniel Merrill
- Adam R. Messier
- Elizabeth Mary Meyer
- Audrey Micallef
- Alexa Michaud
- Jeffrey S. Michaud
All providers in Lewiston, ME · Substance Use Disorder Rehabilitation Clinic/Center in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.