Healthcare Provider Details

I. General information

NPI: 1043489511
Provider Name (Legal Business Name): PRIMARY HEALTH NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2008
Last Update Date: 07/20/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1291 RUTLEDGE RD
TRANSFER PA
16154-2225
US

IV. Provider business mailing address

63 PITT ST
SHARON PA
16146-2102
US

V. Phone/Fax

Practice location:
  • Phone: 724-962-3553
  • Fax: 724-962-3630
Mailing address:
  • Phone: 724-342-3002
  • Fax: 724-342-1942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. CARL A SIZER III
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CPA
Phone: 724-342-0126