Organization Name: | PRIMARY HEALTH NETWORK |
NPI Number: | 1104257310 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DREW C PIERCE (CEO) |
Mailing Address: | 21 S Brown St Lewistown |
State: | PA US |
Postal Code: | 170448126 |
Phone Number: | 7174470340 |
Fax Number: | 7174470344 |
NPI Enumeration Date: | 12/13/2013 |
NPI Last Update Date: | 02/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |