MEDICARE: PRIMARY CARE CENTER OF THOMASTON, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	033176	CT

General Provider Information

NPI Number	:	1265498190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY CARE CENTER OF THOMASTON, LLC

Provider Business Mailing Address
First Line	:	205 S MAIN ST
Second Line	:
City	:	THOMASTON
State	:	CT
Zip	:	06787-1740
Country	:	US
Telephone Number	:	860-283-6255
Fax Number	:	860-283-6202

Provider Business Practice Location Address
First Line	:	205 S MAIN ST
Second Line	:
City	:	THOMASTON
State	:	CT
Zip	:	06787-1740
Country	:	US
Telephone Number	:	860-283-6255
Fax Number	:	860-283-6202

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. GEORGE MEHRIZ BARCHINI
Credential	:	M.D.
Telephone Number	:	860-283-6255

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	08/22/2020

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