| Organization Name: | FAMILY MEDICAL CARE OF LAWRENCE COUNTY, INC |
| NPI Number: | 1780011460 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES LARIMER GARDNER (PRESIDENT/OWNER) |
| Mailing Address: | 150 N New Castle St New Wilmington |
| State: | PA US |
| Postal Code: | 161421019 |
| Phone Number: | 7249463564 |
| Fax Number: | 7249462156 |
| NPI Enumeration Date: | 09/26/2013 |
| NPI Last Update Date: | 09/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | SP013176 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |