Provider Demographics
NPI:1093253700
Name:PRIME FOOT AND ANKLE CARE, LLC
Entity Type:Organization
Organization Name:PRIME FOOT AND ANKLE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-667-8200
Mailing Address - Street 1:817 MERRIMACK ST
Mailing Address - Street 2:UNIT 1C
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-3571
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 MEETING HOUSE RD STE 5
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-2734
Practice Address - Country:US
Practice Address - Phone:978-452-0657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty