Healthcare Provider Details

I. General information

NPI: 1669909388
Provider Name (Legal Business Name): PRIMARIAHEALTH, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9365 COUNSELORS ROW STE 210
INDIANAPOLIS IN
46240-6418
US

IV. Provider business mailing address

ATTN BOX 360165 ROSS ST 154-0455
PITTSBURGH PA
15262-0001
US

V. Phone/Fax

Practice location:
  • Phone: 713-461-2915
  • Fax:
Mailing address:
  • Phone: 713-461-2915
  • Fax: 737-747-5926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01078373A
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number01078373A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number01078373A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHERI SZOKOLAY
Title or Position: DIRECTOR REVENUE CYCLE
Credential:
Phone: 844-969-0686