Organization Name: | SUNBURY PRIMARY CARE, P.A. |
NPI Number: | 1679668180 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID L SAVELL (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 775 N Main Rd Winterport |
State: | ME US |
Postal Code: | 04496 |
Phone Number: | 2072235074 |
Fax Number: | 2072235953 |
NPI Enumeration Date: | 10/03/2006 |
NPI Last Update Date: | 06/04/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |