Organization
MERRIMACK VALLEY PET PC
Active
Other names
New England PET Imaging System
Organization subpart
No
Provider details
NPI number
Authorized official
MARK R TAYLOR (CEO)
(978) 933-9311
Entity
Organization
Contact information
Practice address
185 QUEEN CITY AVE, MANCHESTER, NH 03101-7121
(603) 663-2370
(603) 663-2379
Mailing address
35 NEW ENGLAND BUSINESS CENTER DR STE 103, ANDOVER, MA 01810-1080
(978) 933-9311
(978) 933-7820
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
446R
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15Y002275MA02
BLUE CROSS OF NH
—
05
—
30813476
—
NH
01
—
3184391
AETNA
—
01
—
626241
HARVARD PILGRIM
—
01
—
685730
TUFTS
—
Enumeration date
05/27/2006
Last updated
01/16/2025
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