Provider Demographics
NPI:1093946626
Name:PRIMARY HEALTH NETWORK
Entity Type:Organization
Organization Name:PRIMARY HEALTH NETWORK
Other - Org Name:GREENVILLE COMMUNITY HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIZER
Authorized Official - Suffix:III
Authorized Official - Credentials:CPA
Authorized Official - Phone:724-342-0126
Mailing Address - Street 1:63 PITT ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-2102
Mailing Address - Country:US
Mailing Address - Phone:724-342-3002
Mailing Address - Fax:724-342-1942
Practice Address - Street 1:348 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:PA
Practice Address - Zip Code:16125-2608
Practice Address - Country:US
Practice Address - Phone:724-588-5250
Practice Address - Fax:724-588-5253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-30
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0089923Medicaid
PA1007578460096Medicaid
PA1007578460096Medicaid
PA068965Medicare PIN