MEDICARE: PRIMARY CARE SPECIALISTS INC.

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	261QP2300X	Primary Care Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C15355	OTHER	MA	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346208196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY CARE SPECIALISTS INC.

Provider Business Mailing Address
First Line	:	190 GROTON RD
Second Line	:	SUITE 110
City	:	AYER
State	:	MA
Zip	:	01432-1124
Country	:	US
Telephone Number	:	978-772-2780
Fax Number	:	978-772-6959

Provider Business Practice Location Address
First Line	:	190 GROTON RD
Second Line	:	SUITE 110
City	:	AYER
State	:	MA
Zip	:	01432-1124
Country	:	US
Telephone Number	:	978-772-2780
Fax Number	:	978-772-6959

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. TERRANCE C HACK
Credential	:	M.D., F.A.C.C.
Telephone Number	:	978-772-2780

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	10/20/2011

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AYER, MA
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AYER, MA
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Directions to “PRIMARY CARE SPECIALISTS INC. ” Practice Location

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