Provider Demographics
NPI:1598795080
Name:PRINCETON PRIMARY CARE
Entity Type:Organization
Organization Name:PRINCETON PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCELLHINEY
Authorized Official - Suffix:
Authorized Official - Credentials:MLT ASCP MT HEW
Authorized Official - Phone:812-385-1071
Mailing Address - Street 1:2022 SHERMAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IN
Mailing Address - Zip Code:47670
Mailing Address - Country:US
Mailing Address - Phone:812-385-1071
Mailing Address - Fax:812-385-8793
Practice Address - Street 1:2022 SHERMAN DRIVE
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670
Practice Address - Country:US
Practice Address - Phone:812-385-1071
Practice Address - Fax:812-385-8793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty