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General NPI Number Information
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NPI Number | 1316291495
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Entity Type | Organization
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Legal Business Name | PRIMARY HEALTH SERVICES CENTER
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Dates
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Enumeration Date | 10/29/2012
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Last Update Date | 04/15/2021
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Provider Practice Location Address
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Address Line | 2915 BETIN AVE
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City | MONROE
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State | LA
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Zip | 71201-7257
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Country | US
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Telephone | 318-651-9945
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Fax | 318-410-0680
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Provider Business Mailing Address
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Address Line | PO BOX 7495
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City | MONROE
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State | LA
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Zip | 71211-7495
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Country | US
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Telephone | 318-388-1250
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Fax | 318-388-0948
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Authorized Official
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Title or Position | CEO
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Name | MRS. CATHERINE M. TONORE
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Credential |
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Telephone | 318-388-1250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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