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Organization
MERRIMACK VALLEY TRAUMA SERVICES, INC.
Active
Organization
MERRIMACK VALLEY TRAUMA SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNE PATRICIA CORBIN (EXECUTIVE DIRECTOR)
(843) 400-3040
Entity
Organization
Contact information
Practice address
5900 CORE RD STE 401, NORTH CHARLESTON, SC 29406-6069
(843) 400-3040
(843) 400-3040
Mailing address
5900 CORE RD STE 401, NORTH CHARLESTON, SC 29406-6069
(843) 400-3040
(843) 400-3040
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP9315
—
SC
Enumeration date
05/19/2010
Last updated
02/17/2023
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