Healthcare Provider Details

I. General information

NPI: 1851214399
Provider Name (Legal Business Name): CARECENTRAL PRIMARY CARE MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

286 WASHINGTON ST
STOUGHTON MA
02072-1763
US

IV. Provider business mailing address

286 WASHINGTON ST
STOUGHTON MA
02072-1763
US

V. Phone/Fax

Practice location:
  • Phone: 781-341-2800
  • Fax: 781-341-2828
Mailing address:
  • Phone: 781-341-2800
  • Fax: 781-341-2828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RENEE WILSON
Title or Position: OWNER
Credential: MD
Phone: 781-375-7105