Basic Information
| Provider Information | |||||||||
| NPI: | 1194797670 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HARFORD PRIMARY CARE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 615 W MACPHAIL RD | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | BEL AIR | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210144309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434625093 | ||||||||
| FaxNumber: | 4106388915 | ||||||||
| Practice Location | |||||||||
| Address1: | 615 W MACPHAIL RD | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | BEL AIR | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210144309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434625093 | ||||||||
| FaxNumber: | 4106388915 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2006 | ||||||||
| LastUpdateDate: | 12/09/2021 | ||||||||
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| AuthorizedOfficialLastName: | PRIOLO | ||||||||
| AuthorizedOfficialFirstName: | MARCUS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 4436433340 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.