Provider Demographics
NPI:1316003429
Name:CONCORD PRIMARY CARE,INC
Entity Type:Organization
Organization Name:CONCORD PRIMARY CARE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAIN
Authorized Official - Prefix:DR
Authorized Official - First Name:VINEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:978-318-0007
Mailing Address - Street 1:PO BOX 2669
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-6669
Mailing Address - Country:US
Mailing Address - Phone:978-318-0007
Mailing Address - Fax:978-318-0056
Practice Address - Street 1:131 OLD ROAD TO 9 ACRE COR
Practice Address - Street 2:SUITE 810 JCB
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4181
Practice Address - Country:US
Practice Address - Phone:978-318-0007
Practice Address - Fax:978-318-0056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154169207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ18209OtherBCBS PROVIDER#
MA137610OtherTUFTS PROVIDER #
MA6405OtherFALLON PROVIDER #
MA17782053OtherTRICARE
MAM18857OtherBCBSGROUP #
MA2033845OtherFIRST HEALTH
MA2115197OtherUNITED HEALTH CARE
MA693861OtherTUFTS GROUP #
MA400094OtherHPHC
MA91080OtherFALLON GROUP #
MA1012166OtherAETNA PROVIDER #
MA3168794Medicaid
MA3680770OtherAETNA GROUP #
MA9734601Medicaid
MA6405OtherFALLON PROVIDER #
MAM21549Medicare ID - Type UnspecifiedGROUP #
MA2115197OtherUNITED HEALTH CARE