Provider Demographics
NPI:1295867620
Name:PRIMARY HEALTH NETWORK
Entity Type:Organization
Organization Name:PRIMARY HEALTH NETWORK
Other - Org Name:SHEAKLEYVILLE HEALTH 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 1:63 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 1:3339 PERRY HIGHWAY
Practice Address - Street 2:
Practice Address - City:SHEAKLEYVILLE
Practice Address - State:PA
Practice Address - Zip Code:16151-0000
Practice Address - Country:US
Practice Address - Phone:724-253-3428
Practice Address - Fax:724-253-3029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007578460019Medicaid
OH2635063Medicaid
PA391880Medicare Oscar/Certification
PA068965Medicare PIN