Provider Demographics
NPI:1578687281
Name:PRIMARY CARE ASSOCIATES, PC
Entity Type:Organization
Organization Name:PRIMARY CARE ASSOCIATES, PC
Other - Org Name:PRIMARY CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FORMER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:I
Authorized Official - Last Name:GEISBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-716-6008
Mailing Address - Street 1:2000 E GREENVILLE ST
Mailing Address - Street 2:SUITE #1600
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1580
Mailing Address - Country:US
Mailing Address - Phone:864-716-6008
Mailing Address - Fax:864-716-6732
Practice Address - Street 1:2000 E. GREENVILLE ST.
Practice Address - Street 2:SUITE #1600
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621
Practice Address - Country:US
Practice Address - Phone:864-716-6008
Practice Address - Fax:864-716-6732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP1233Medicaid
SC4871Medicare PIN