Provider Demographics
NPI:1316018781
Name:PRIMARY AND URGENT CARE LLC
Entity Type:Organization
Organization Name:PRIMARY AND URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHER
Authorized Official - Middle Name:B
Authorized Official - Last Name:ANSARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-785-9900
Mailing Address - Street 1:PO BOX 3910
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22402-3910
Mailing Address - Country:US
Mailing Address - Phone:540-785-9900
Mailing Address - Fax:540-785-9960
Practice Address - Street 1:231 GARRISONVILLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-1527
Practice Address - Country:US
Practice Address - Phone:540-288-9888
Practice Address - Fax:540-288-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010052483OtherVA PREMIER
VACK8010OtherRAILROAD MEDICARE
VA2160878OtherUNITED HEALTH CARE
VAJ066OtherCARE FIRST
VA435980OtherANTHEM BLUE CROSS BLUE SHIELD
VA435980OtherANTHEM BLUE CROSS BLUE SHIELD
VACK8010OtherRAILROAD MEDICARE