Provider Demographics
NPI:1578695904
Name:PRIMARY HEALTH NETWORK
Entity Type:Organization
Organization Name:PRIMARY HEALTH NETWORK
Other - Org Name:THE CENTER FOR HEALTH AND WELL BEING
Other - Org Type:Other Name
Authorized Official - Title/Position:ACTING CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BURICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-342-3002
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:724-704-8886
Mailing Address - Fax:724-342-1942
Practice Address - Street 1:350 SHARON NEW CASTLE RD
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-1576
Practice Address - Country:US
Practice Address - Phone:724-981-8070
Practice Address - Fax:724-981-7025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007578460075Medicaid
OH2590478Medicaid
PA1007578460075Medicaid
PA391894Medicare Oscar/Certification