Provider Demographics
NPI:1497176663
Name:PRIMARY CARE PARTNERS LLC
Entity Type:Organization
Organization Name:PRIMARY CARE PARTNERS LLC
Other - Org Name:MARCIA MCINNES, MD-PRIMARY CARE PARTNERS AFFILIATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-782-3300
Mailing Address - Street 1:PO BOX 3001
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-0598
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:254 ROUTE 202-206 NORTH
Practice Address - Street 2:
Practice Address - City:PLUCKEMIN
Practice Address - State:NJ
Practice Address - Zip Code:07978
Practice Address - Country:US
Practice Address - Phone:908-234-9777
Practice Address - Fax:908-234-2485
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIMARY CARE PARTNERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty