Lifeline Primary Care Llc | |
662 Commons Way Bldg I4 Toms River NJ 08755-6431 | |
(732) 279-3681 | |
(732) 279-6043 |
Full Name | Lifeline Primary Care Llc |
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Speciality | Clinic/Center |
Location | 662 Commons Way Bldg I4, Toms River, New Jersey |
Authorized Official Name and Position | Palakkumar Patel (OWNER) |
Authorized Official Contact | 9083288491 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lifeline Primary Care Llc 662 Commons Way Bldg I4 Toms River NJ 08755-6431 Ph: (732) 279-3681 | Lifeline Primary Care Llc 662 Commons Way Bldg I4 Toms River NJ 08755-6431 Ph: (732) 279-3681 |
NPI Number | 1770947145 |
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Provider Enumeration Date | 04/11/2016 |
Last Update Date | 07/21/2022 |
Medicare PECOS PAC ID | 7315225919 |
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Medicare Enrollment ID | O20161102002073 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770947145 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 25MA09556300 (New Jersey) | Primary |
Provider Name | Palakkumar Patel |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1053559427 PECOS PAC ID: 7517012446 Enrollment ID: I20150211000266 |
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