Provider Demographics
NPI:1992035380
Name:PRIMARY & PREVENTIVE CARE, INC.
Entity Type:Organization
Organization Name:PRIMARY & PREVENTIVE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-680-2442
Mailing Address - Street 1:20 EAST ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-1638
Mailing Address - Country:US
Mailing Address - Phone:781-826-3146
Mailing Address - Fax:781-826-1110
Practice Address - Street 1:20 EAST ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-1638
Practice Address - Country:US
Practice Address - Phone:781-826-3146
Practice Address - Fax:781-826-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17300000X261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care