Provider Demographics
NPI:1346208196
Name:PRIMARY CARE SPECIALISTS INC.
Entity Type:Organization
Organization Name:PRIMARY CARE SPECIALISTS INC.
Other - Org Name:PRIMARY CARE CARDIOLOGY INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACC
Authorized Official - Phone:978-772-2780
Mailing Address - Street 1:190 GROTON RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:AYER
Mailing Address - State:MA
Mailing Address - Zip Code:01432-1124
Mailing Address - Country:US
Mailing Address - Phone:978-772-2780
Mailing Address - Fax:978-772-6959
Practice Address - Street 1:190 GROTON RD
Practice Address - Street 2:SUITE 110
Practice Address - City:AYER
Practice Address - State:MA
Practice Address - Zip Code:01432-1124
Practice Address - Country:US
Practice Address - Phone:978-772-2780
Practice Address - Fax:978-772-6959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAC15355OtherRAIL ROAD MEDICARE
MA9765832Medicaid
MA9765832Medicaid