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General NPI Number Information
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NPI Number | 1992141600
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Entity Type | Organization
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Legal Business Name | PRIMARY MEDICAL CARE, INC.
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Dates
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Enumeration Date | 05/21/2013
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Last Update Date | 08/12/2013
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Provider Practice Location Address
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Address Line | 785 ROCKDALE AVENUE
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City | NEW BEDFORD
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State | MA
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Zip | 02740
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Country | US
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Telephone | 508-997-1229
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Fax | 508-997-1220
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Provider Business Mailing Address
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Address Line | 785 ROCKDALE AVENUE
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City | NEW BEDFORD
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State | MA
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Zip | 02740
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Country | US
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Telephone | 508-997-1229
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Fax | 508-997-1220
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | PETER MATTHEW HORAN
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Credential | M.D.
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Telephone | 508-997-1229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 30257
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License Number State | MA
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