Provider Demographics
NPI:1265639553
Name:PRIMARY HEALTH NETWORK
Entity Type:Organization
Organization Name:PRIMARY HEALTH NETWORK
Other - Org Name:HOFFMAN MEMORIAL MEDICAL CENTER
Other - Org Type:Doing Business As
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 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:724-342-3002
Mailing Address - Fax:724-342-1942
Practice Address - Street 1:419 KELLYS WAY
Practice Address - Street 2:
Practice Address - City:EAST BRADY
Practice Address - State:PA
Practice Address - Zip Code:16028
Practice Address - Country:US
Practice Address - Phone:724-526-5600
Practice Address - Fax:724-526-3289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QF0400X, 261QF0400X
PA332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
No332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007578460023Medicaid
PA1007578460023Medicaid
PA068965Medicare PIN