Provider Demographics
NPI:1285882969
Name:PRIMARY CARE GROUP INC
Entity type:Organization
Organization Name:PRIMARY CARE GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:FITTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-943-2600
Mailing Address - Street 1:340 THOMPSON RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-1509
Mailing Address - Country:US
Mailing Address - Phone:508-943-2600
Mailing Address - Fax:
Practice Address - Street 1:340 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-1509
Practice Address - Country:US
Practice Address - Phone:508-943-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA155855207R00000X
MAMA216396207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty