Provider Demographics
NPI:1235696329
Name:CAREFIRST ACO, LLC
Entity Type:Organization
Organization Name:CAREFIRST ACO, LLC
Other - Org Name:PREMIER HEALTHCARE SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-516-3972
Mailing Address - Street 1:1225 W COUNTY ROAD 48
Mailing Address - Street 2:
Mailing Address - City:BUSHNELL
Mailing Address - State:FL
Mailing Address - Zip Code:33513-8973
Mailing Address - Country:US
Mailing Address - Phone:352-516-3972
Mailing Address - Fax:
Practice Address - Street 1:1225 W COUNTY ROAD 48
Practice Address - Street 2:
Practice Address - City:BUSHNELL
Practice Address - State:FL
Practice Address - Zip Code:33513-8973
Practice Address - Country:US
Practice Address - Phone:352-516-3972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty