Provider Demographics
NPI:1093920357
Name:COORDINATED PRIMRARY CARE INC
Entity Type:Organization
Organization Name:COORDINATED PRIMRARY CARE INC
Other - Org Name:HEALTHALLIANCE NEUROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COFONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-466-2185
Mailing Address - Street 1:50 MEMORIAL DR
Mailing Address - Street 2:SUITE 211
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-2238
Mailing Address - Country:US
Mailing Address - Phone:978-537-3355
Mailing Address - Fax:
Practice Address - Street 1:50 MEMORIAL DR
Practice Address - Street 2:SUITE 211
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2238
Practice Address - Country:US
Practice Address - Phone:978-537-3355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM20928Medicare ID - Type UnspecifiedGROUP NUMBER