Provider Demographics
NPI:1417938747
Name:PRIMARY CARE ASSOCIATES OF BUTLER, PC
Entity Type:Organization
Organization Name:PRIMARY CARE ASSOCIATES OF BUTLER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KREBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-284-4879
Mailing Address - Street 1:480 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4780
Mailing Address - Country:US
Mailing Address - Phone:724-282-1530
Mailing Address - Fax:724-282-1541
Practice Address - Street 1:480 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4780
Practice Address - Country:US
Practice Address - Phone:724-282-1530
Practice Address - Fax:724-282-1541
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUTLER HEALTHSYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-14
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012711510002Medicaid
PA688070Medicare PIN