Provider Demographics
NPI:1164808440
Name:PRIMARY CARE PARTNERS, LLC
Entity Type:Organization
Organization Name:PRIMARY CARE PARTNERS, LLC
Other - Org Name:MONTVILLE FAMILY PRACTICE- PRIMARY CARE PARTNERS AFFILIATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MORANDI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:856-782-3300
Mailing Address - Street 1:PO BOX 2403
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-6403
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-762-1751
Practice Address - Street 1:137 MAIN RD
Practice Address - Street 2:
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045-9231
Practice Address - Country:US
Practice Address - Phone:973-402-0025
Practice Address - Fax:973-402-3487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty