Provider Demographics
NPI:1457540072
Name:PRIMARY CARE HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:PRIMARY CARE HEALTH SERVICES, INC
Other - Org Name:ALMA ILLERY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILFORD
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-244-4700
Mailing Address - Street 1:7227 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-1814
Mailing Address - Country:US
Mailing Address - Phone:412-244-4700
Mailing Address - Fax:412-244-4992
Practice Address - Street 1:7227 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208-1814
Practice Address - Country:US
Practice Address - Phone:412-244-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)