Healthcare Provider Details

I. General information

NPI: 1568292423
Provider Name (Legal Business Name): BETH ISRAEL LAHEY HEALTH PRIMARY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 COMMERCE BLVD
MIDDLEBORO MA
02346-1030
US

IV. Provider business mailing address

41 MALL RD
BURLINGTON MA
01805-0001
US

V. Phone/Fax

Practice location:
  • Phone: 774-373-8630
  • Fax: 774-373-8628
Mailing address:
  • Phone: 781-744-8085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALEX BARKER
Title or Position: PRESIDENT
Credential:
Phone: 781-552-0022