Healthcare Provider Details

I. General information

NPI: 1356402697
Provider Name (Legal Business Name): COORDINATED PRIMARY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL RD STE 1B
LEOMINSTER MA
01453-2253
US

IV. Provider business mailing address

100 HOSPITAL RD STE 1B
LEOMINSTER MA
01453-2253
US

V. Phone/Fax

Practice location:
  • Phone: 978-466-4550
  • Fax: 978-466-4507
Mailing address:
  • Phone: 978-466-4550
  • Fax: 978-466-4507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL COFONE
Title or Position: CFO
Credential:
Phone: 978-466-2185