Provider Demographics
NPI:1508018771
Name:PRIMARY HEALTH, LLC
Entity Type:Organization
Organization Name:PRIMARY HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PILESKI
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:207-266-4006
Mailing Address - Street 1:541 MASON BAY RD
Mailing Address - Street 2:
Mailing Address - City:JONESPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04649-3501
Mailing Address - Country:US
Mailing Address - Phone:207-497-2996
Mailing Address - Fax:
Practice Address - Street 1:34 DOWNEAST HWY
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1731
Practice Address - Country:US
Practice Address - Phone:207-266-4006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-19
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME9062Medicare PIN