Provider Demographics
NPI:1992414502
Name:PRIMARY CARE PRACTITIONERS, LLC
Entity type:Organization
Organization Name:PRIMARY CARE PRACTITIONERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:240-388-1903
Mailing Address - Street 1:606 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2711
Mailing Address - Country:US
Mailing Address - Phone:240-388-1903
Mailing Address - Fax:
Practice Address - Street 1:11604 BEDFORD RD NE STE 8
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-6994
Practice Address - Country:US
Practice Address - Phone:240-388-1903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty