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General NPI Number Information
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NPI Number | 1649061359
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE HEALTH SERVICES, INC,
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 1539 LINCOLN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15206-1220
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Country | US
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Telephone | 412-441-4686
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Fax |
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Provider Business Mailing Address
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Address Line | 1539 LINCOLN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15206-1220
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Country | US
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Telephone | 412-441-4686
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | SERITA DENISE VENSON
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Credential |
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Telephone | 412-244-4973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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