Lighthouse Primary Care Pc | |
315 Main St Ste 101 North Reading MA 01864-1326 | |
(978) 276-0100 | |
(978) 276-0041 |
Full Name | Lighthouse Primary Care Pc |
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Speciality | Family Medicine |
Location | 315 Main St Ste 101, North Reading, Massachusetts |
Authorized Official Name and Position | Kenneth P Mcwha (PRESIDENT) |
Authorized Official Contact | 9782760100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lighthouse Primary Care Pc 315 Main St Ste 101 North Reading MA 01864-1326 Ph: (978) 276-0100 | Lighthouse Primary Care Pc 315 Main St Ste 101 North Reading MA 01864-1326 Ph: (978) 276-0100 |
NPI Number | 1588290324 |
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Provider Enumeration Date | 03/12/2020 |
Last Update Date | 03/12/2020 |
Medicare PECOS PAC ID | 4486084217 |
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Medicare Enrollment ID | O20200420000914 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588290324 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Kenneth P Mcwha |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1215974985 PECOS PAC ID: 3173429594 Enrollment ID: I20031208000856 |
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