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General NPI Number Information
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NPI Number | 1548538473
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE PARTNERS
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Dates
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Enumeration Date | 12/07/2011
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Last Update Date | 11/02/2012
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Provider Practice Location Address
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Address Line | 2756 POST RD
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City | WARWICK
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State | RI
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Zip | 02886-3003
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Country | US
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Telephone | 401-691-6000
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Fax | 401-738-7718
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Provider Business Mailing Address
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Address Line | 2756 POST RD
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City | WARWICK
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State | RI
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Zip | 02886-3003
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Country | US
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Telephone | 401-691-6000
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Fax | 401-738-7718
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DAVID LAUTERBACH
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Credential | ACSW
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Telephone | 401-691-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | RI
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