| Primary Convenient Care Corporation | |
|
3763 East Main Street New Waterford OH 44445-0001 | |
| (330) 420-2025 | |
| (330) 967-4444 |
| Full Name | Primary Convenient Care Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 3763 East Main Street, New Waterford, Ohio |
| Authorized Official Name and Position | Brooke Boyd (CO OWNER) |
| Authorized Official Contact | 3308537086 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Convenient Care Corporation 3763 East Main Street New Waterford OH 44445-0001 Ph: (330) 420-2025 | Primary Convenient Care Corporation 3763 East Main Street New Waterford OH 44445-0001 Ph: (330) 420-2025 |
| NPI Number | 1558951392 |
|---|---|
| Provider Enumeration Date | 01/26/2021 |
| Last Update Date | 03/01/2022 |
| Medicare PECOS PAC ID | 9830507185 |
|---|---|
| Medicare Enrollment ID | O20210426002099 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558951392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Brooke Loren Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871063701 PECOS PAC ID: 2961734058 Enrollment ID: I20191022002299 |
| Provider Name | Kaley Nicole Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407341977 PECOS PAC ID: 7517388754 Enrollment ID: I20200526003213 |