1620 Primary Care, Pllc | |
110 Long Pond Rd Ste 110 Plymouth MA 02360-2642 | |
(508) 591-3111 | |
(774) 283-9949 |
Full Name | 1620 Primary Care, Pllc |
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Speciality | Family Medicine |
Location | 110 Long Pond Rd Ste 110, Plymouth, Massachusetts |
Authorized Official Name and Position | Aaron Maloy (NURSE PRACTITIONER, OWNER) |
Authorized Official Contact | 5085911111 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1620 Primary Care, Pllc 110 Long Pond Rd Ste 110 Plymouth MA 02360-2642 Ph: (508) 591-3111 | 1620 Primary Care, Pllc 110 Long Pond Rd Ste 110 Plymouth MA 02360-2642 Ph: (508) 591-3111 |
NPI Number | 1174214464 |
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Provider Enumeration Date | 05/17/2023 |
Last Update Date | 05/17/2023 |
Medicare PECOS PAC ID | 2769845700 |
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Medicare Enrollment ID | O20230824000395 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174214464 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Aaron Maloy |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922501824 PECOS PAC ID: 2567727530 Enrollment ID: I20180522000255 |
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