| Organization Name: | PRIMARY CARE HEALTH SERVICES, INC. |
| NPI Number: | 1144390683 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILFORD A. PAYNE (EXECUTIVE DIRECTOR) |
| Mailing Address: | 404 Braddock Ave Braddock |
| State: | PA US |
| Postal Code: | 151041804 |
| Phone Number: | 4123516300 |
| Fax Number: | 4123516500 |
| NPI Enumeration Date: | 11/09/2006 |
| NPI Last Update Date: | 10/19/2010 |
| 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: | |