# MERRIMACK VALLEY TRAUMA SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053630863
- **Authorized official:** DIANNE PATRICIA CORBIN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (843) 400-3040

## Contact information

- **Practice address:** 5900 CORE RD STE 401, NORTH CHARLESTON, SC 29406-6069
- **Practice address phone:** (843) 400-3040
- **Practice address fax:** (843) 400-3040
- **Mailing address:** 5900 CORE RD STE 401, NORTH CHARLESTON, SC 29406-6069
- **Mailing address phone:** (843) 400-3040
- **Mailing address fax:** (843) 400-3040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 05/19/2010
- **Last updated:** 02/17/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP9315 | — | SC |