| First Care Providers, LLC | |
|
647 Main Ave Ste 207 Passaic NJ 07055-4962 | |
| (973) 735-1231 | |
| (973) 735-1232 |
| Full Name | First Care Providers, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 647 Main Ave Ste 207, Passaic, New Jersey |
| Authorized Official Name and Position | Anita Thomas (CEO) |
| Authorized Official Contact | 9737351231 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| First Care Providers, LLC Po Box 315 Lodi NJ 07644-0315 Ph: (973) 735-1231 | First Care Providers, LLC 647 Main Ave Ste 207 Passaic NJ 07055-4962 Ph: (973) 735-1231 |
| NPI Number | 1023315223 |
|---|---|
| Provider Enumeration Date | 02/24/2011 |
| Last Update Date | 02/22/2022 |
| Certification Date | 02/22/2022 |
| Medicare PECOS PAC ID | 9032396700 |
|---|---|
| Medicare Enrollment ID | O20110606000519 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023315223 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0400380833 (New Jersey) | Primary |
| Provider Name | Homer L Nelson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578667044 PECOS PAC ID: 1153371521 Enrollment ID: I20050125000272 |
| Provider Name | Anita Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245422740 PECOS PAC ID: 3173619574 Enrollment ID: I20071017000199 |
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