Provider Demographics
NPI:1487201273
Name:PA-RTNERS IN PRIMARY CARE, LLC
Entity Type:Organization
Organization Name:PA-RTNERS IN PRIMARY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:CHARETTE
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:330-447-7794
Mailing Address - Street 1:436 MISTEE DRIVE SW
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663
Mailing Address - Country:US
Mailing Address - Phone:330-447-7794
Mailing Address - Fax:
Practice Address - Street 1:436 MISTEE DRIVE SW
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663
Practice Address - Country:US
Practice Address - Phone:330-447-7794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PA-RTNERS IN PRIMARY CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center