MEDICARE: PRIMACARE HEALTH SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	305S00000X	Point of Service

General Provider Information

NPI Number	:	1043487465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMACARE HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	1175 S US HIGHWAY 1
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32962-5606
Country	:	US
Telephone Number	:	772-794-0030
Fax Number	:	772-794-1386

Provider Business Practice Location Address
First Line	:	1175 S US HIGHWAY 1
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32962-5606
Country	:	US
Telephone Number	:	772-794-0030
Fax Number	:	772-794-1386

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MRS. TONI P TERESI
Credential	:
Telephone Number	:	772-794-0030

Provider Enumeration Date	:	05/14/2008
Last Update Date	:	05/14/2008

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Directions to “PRIMACARE HEALTH SERVICES, INC. ” Practice Location

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