Provider Demographics
NPI:1043345549
Name:PRIMARY HEALTHCARE ASSOCIATES, INC.
Entity Type:Organization
Organization Name:PRIMARY HEALTHCARE ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAYEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-744-0221
Mailing Address - Street 1:2111 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-2428
Mailing Address - Country:US
Mailing Address - Phone:330-744-0221
Mailing Address - Fax:330-744-4716
Practice Address - Street 1:2111 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-2428
Practice Address - Country:US
Practice Address - Phone:330-744-0221
Practice Address - Fax:330-744-4716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35043267H207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0400327OtherUHC
OH289425117005OtherMMO
OH0431732Medicaid
OHP006352OtherGATEWAY
OH000000138793OtherANTHEM
OH000000139083OtherUNISON
OH28942511700OtherBWC
OH0400327OtherUHC
OH28942511700OtherBWC
OH=========028OtherCARESOURCE
OH0431732Medicaid