Provider Demographics
NPI:1801190921
Name:FOUNDATION PRIMARY CARE, LLC
Entity Type:Organization
Organization Name:FOUNDATION PRIMARY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BREEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:901-516-0843
Mailing Address - Street 1:7690 WOLF RIVER CIR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1744
Mailing Address - Country:US
Mailing Address - Phone:901-756-1231
Mailing Address - Fax:901-755-1590
Practice Address - Street 1:7690 WOLF RIVER CIR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1744
Practice Address - Country:US
Practice Address - Phone:901-756-1231
Practice Address - Fax:901-755-1590
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METHODIST HOSPITAL METHODIST HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty