Provider Demographics
NPI:1831581438
Name:PRIMARY HEALTH, LLC
Entity type:Organization
Organization Name:PRIMARY HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE LIASON
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:TAINTER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:207-667-2288
Mailing Address - Street 1:34 DOWNEAST HWY
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1731
Mailing Address - Country:US
Mailing Address - Phone:207-667-2288
Mailing Address - Fax:207-667-6888
Practice Address - Street 1:34 DOWNEAST HWY
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1731
Practice Address - Country:US
Practice Address - Phone:207-667-2288
Practice Address - Fax:207-667-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1299009-000000261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEPTAN9062Medicare UPIN