Healthcare Provider Details

I. General information

NPI: 1679115166
Provider Name (Legal Business Name): PRIMA CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2019
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 PLEASANT ST STE 240
FALL RIVER MA
02721-3005
US

IV. Provider business mailing address

277 PLEASANT ST
FALL RIVER MA
02721-3005
US

V. Phone/Fax

Practice location:
  • Phone: 508-676-3292
  • Fax:
Mailing address:
  • Phone: 508-676-3292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAUREN GOMES
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 508-676-3292