Provider Demographics
NPI:1760582563
Name:PRIMARY CARE INTERNISTS, INC.
Entity Type:Organization
Organization Name:PRIMARY CARE INTERNISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:W
Authorized Official - Last Name:SWABB
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:937-778-1000
Mailing Address - Street 1:3006 N COUNTY ROAD 25A STE 106
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-1373
Mailing Address - Country:US
Mailing Address - Phone:937-778-1000
Mailing Address - Fax:937-440-4275
Practice Address - Street 1:3006 N COUNTY ROAD 25A STE 106
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1373
Practice Address - Country:US
Practice Address - Phone:937-778-1000
Practice Address - Fax:937-440-4275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005576S207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3011743Medicaid
OH0770162Medicare PIN
OHF55996Medicare UPIN