| Primed Medica Care Pc | |
|
616 Willow Grove Street Unit 1a Hackettstown NJ 07840-1779 | |
| (908) 852-8484 | |
| (908) 852-4197 |
| Full Name | Primed Medica Care Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 616 Willow Grove Street, Hackettstown, New Jersey |
| Authorized Official Name and Position | Ashmita Kavathia (PRACTICE MANAGER) |
| Authorized Official Contact | 9088528484 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primed Medica Care Pc 616 Willow Grove Street Unit 1a Hackettstown NJ 07840-1779 Ph: (908) 852-8484 | Primed Medica Care Pc 616 Willow Grove Street Unit 1a Hackettstown NJ 07840-1779 Ph: (908) 852-8484 |
| NPI Number | 1972619807 |
|---|---|
| Provider Enumeration Date | 08/22/2006 |
| Last Update Date | 08/04/2015 |
| Medicare PECOS PAC ID | 6002874427 |
|---|---|
| Medicare Enrollment ID | O20041230000540 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972619807 | NPI | - | NPPES |
| 8684308 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MA072670 (New Jersey) | Primary |
| Provider Name | Sanjay G Kavathia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124078142 PECOS PAC ID: 1557329984 Enrollment ID: I20050105000072 |
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