Provider Demographics
NPI:1366624579
Name:LIMESTONE PRIMARY CARE PHYSICIANS, LLP
Entity Type:Organization
Organization Name:LIMESTONE PRIMARY CARE PHYSICIANS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:REYNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-632-1400
Mailing Address - Street 1:18 LIMESTONE DR STE 5
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8602
Mailing Address - Country:US
Mailing Address - Phone:716-632-1400
Mailing Address - Fax:
Practice Address - Street 1:18 LIMESTONE DR STE 5
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8602
Practice Address - Country:US
Practice Address - Phone:716-632-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02238911Medicaid
NY02238911Medicaid