| Merrimack Valley Trauma Services, Inc. | |
|
5900 Core Rd Ste 401 North Charleston SC 29406-6069 | |
| (843) 400-3040 | |
| (843) 400-3040 |
| Full Name | Merrimack Valley Trauma Services, Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5900 Core Rd Ste 401, North Charleston, South Carolina |
| Authorized Official Name and Position | Dianne Patricia Corbin (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8434003040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Merrimack Valley Trauma Services, Inc. 5900 Core Rd Ste 401 North Charleston SC 29406-6069 Ph: (843) 400-3040 | Merrimack Valley Trauma Services, Inc. 5900 Core Rd Ste 401 North Charleston SC 29406-6069 Ph: (843) 400-3040 |
| NPI Number | 1053630863 |
|---|---|
| Provider Enumeration Date | 05/19/2010 |
| Last Update Date | 02/17/2023 |
| Certification Date | 02/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053630863 | NPI | - | NPPES |
| GP9315 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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