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NPI Code Detail

MEDICARE: FOUNDATION PRIMARY CARE, LLC

MEDICARE: FOUNDATION PRIMARY CARE, LLC
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
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1801190921
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOUNDATION PRIMARY CARE, LLC
Provider Business Mailing Address
First Line : 7690 WOLF RIVER CIR
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-1744
Country : US
Telephone Number : 901-756-1231
Fax Number : 901-755-1590
Provider Business Practice Location Address
First Line : 7690 WOLF RIVER CIR
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-1744
Country : US
Telephone Number : 901-756-1231
Fax Number : 901-755-1590
Authorized Official
Title or Position : PRESIDENT
Name : WILLIAM BREEN JR.
Credential :
Telephone Number : 901-516-0843
Provider Enumeration Date : 01/04/2011
Last Update Date : 01/04/2011

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Directions to “FOUNDATION PRIMARY CARE, LLC ” Practice Location

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