MEDICARE: PRIMARY HEALTH NETWORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295867620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY HEALTH NETWORK

Provider Business Mailing Address
First Line	:	63 PITT ST
Second Line	:
City	:	SHARON
State	:	PA
Zip	:	16146-2102
Country	:	US
Telephone Number	:	724-342-3002
Fax Number	:	724-342-1942

Provider Business Practice Location Address
First Line	:	3339 PERRY HIGHWAY
Second Line	:
City	:	SHEAKLEYVILLE
State	:	PA
Zip	:	16151-0000
Country	:	US
Telephone Number	:	724-253-3428
Fax Number	:	724-253-3029

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

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/11/2024

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Directions to “PRIMARY HEALTH NETWORK ” Practice Location

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