PRIMARY HEALTH NETWORK (NPI# 1730386467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730386467 |
| Entity Type | Organization |
| Organization Name | PRIMARY HEALTH NETWORK |
| Other Organization Name | JACKSONVILLE FAMILY MEDICINE CENTER |
| Practice Address |
29 Saltsburg Rd Clarksburg PA 15725-7400 |
| Mailing Address |
100 Shenango Ave Sharon PA 16146-1503 |
| Practice Telephone | 7247260300 |
| Practice Fax Number | 7247268812 |
| Mailing Telephone | 7247048886 |
| Mailing Fax Number | 7243421942 |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-04-22 |
| Authorized Official Name | MR. THOMAS BURICH (CEO) |
| Authorized Official Telephone | 7243423002 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007578460071 | 05 |
| Other Name | Type Code |
|---|---|
| Jacksonville Family Medicine Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174179063 | Primary Health Network | Clinic/Center | 811 Grandview Rd Ste 100, Oil City, PA 16301-2077 | 2019-08-15 |
| 1649739319 | Primary Health Network | Clinic/Center | 120 S Martin St, Titusville, PA 16354-1850 | 2019-03-13 |
| 1043711385 | Primary Health Network | Clinic/Center | 152 Zeman Drive, Suite 301, Ebensburg, PA 15931-4130 | 2018-02-22 |
| 1043609480 | Primary Health Network | Clinic/Center | 1885 Market St Ste B, Warren, PA 16365-1278 | 2015-01-22 |
| 1295087617 | Primary Health Network | Clinic/Center | 1555 Shawna Rd., Cherry Tree, PA 15724-9003 | 2012-10-09 |
| 1396074324 | Primary Health Network | Clinic/Center | 802 Mckinley Street, Bolivar, PA 15923-0038 | 2009-12-22 |
| 1275730202 | Primary Health Network | Clinic/Center | 2000 Green St, Farrell, PA 16121-1364 | 2007-07-02 |
| 1265639553 | Primary Health Network | Non-Pharmacy Dispensing Site | 419 Kellys Way, East Brady, PA 16028-1404 | 2007-06-29 |
| 1679779201 | Primary Health Network | Family Medicine | 4210 Crawford Ave, Northern Cambria, PA 15714-1342 | 2007-06-21 |
| 1750413159 | Primary Health Network | Clinic/Center | 197 E Silver St, Sharon, PA 16146-2186 | 2007-03-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PRIMARY HEALTH NETWORK | 100 Shenango Ave, Sharon, PA 16146-1503 |
| Street Address |
29 SALTSBURG RD |
| City | CLARKSBURG |
| State | PA |
| Zip Code | 15725-7400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538147921 | Haney Wahba | Family Medicine | 29 Saltsburg Rd, Clarksburg, PA 15725-7400 | 2006-01-05 |
| 1942834247 | Andrew F Burhett | Counselor | 29 Saltsburg Rd, Clarksburg, PA 15725 | 2020-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306492483 | Megan Ashley Cornman | Nurse Practitioner | 1279 Clarksburg Rd, Clarksburg, PA 15725-7744 | 2019-08-14 |
| 1700421823 | Alaina Stango | Dental Hygienist | 3815 Saltsburg Rd, Clarksburg, PA 15725-7801 | 2019-11-13 |
| 1760659635 | Larry John Kachik | Family Medicine | 135 Kennedy Rd, Clarksburg, PA 15725-8701 | 2008-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730169 | Mary Elizabeth Frame | Registered Nurse | 2645 Crooked Run Rd, Clarksburg, WV 26301-6769 | 2020-11-06 |
| 1871194688 | Billie Sue Griffith | Technician | 366 Chicken Farm Rd, Clarksburg, WV 26301-6550 | 2020-11-06 |
| 1538760566 | John David Barnes | Case Manager/Care Coordinator | 229 W Main St Ste 200, Clarksburg, WV 26301-2966 | 2020-11-05 |
| 1629679881 | Lila Mae Friend | Technician | 160 Sand St, Clarksburg, WV 26301-6008 | 2020-11-04 |
| 1336749126 | Priority Mobility LLC | Non-emergency Medical Transport (VAN) | 12117 Pond Pine Dr, Clarksburg, MD 20871-4474 | 2020-10-29 |
| 1598362220 | Brandie Moore | Technician | 236 Park Blvd, Clarksburg, WV 26301-3521 | 2020-10-06 |
| 1669079604 | Jessica Yvonne Thomas | Military Health Care Provider | 64 Verdant Oak Aly, Clarksburg, MD 20871-3504 | 2020-10-02 |
| 1386250678 | Amanda Culberson | Technician | 4201 Oakmound Dr, Clarksburg, WV 26301-9457 | 2020-09-22 |
| 1396351292 | Carla S Thayer | Technician | 5054 Ash St, Clarksburg, WV 26301-6919 | 2020-09-17 |
| 1528673878 | Ati Holding LLC | Occupational Therapist | 22750 Newcut Rd Ste D1, Clarksburg, MD 20871-5334 | 2020-09-14 |
| Find all providers in CLARKSBURG | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669923538 | Community Care of West Virginia,inc. | Clinic/Center | 1349 Shinnston Pike, Clarksburg, WV 26301-6307 | 2016-10-17 |
| 1871041335 | Community Care of West Virginia,inc. | Clinic/Center | 251 Marietta St, Clarksburg, WV 26301-6313 | 2016-09-13 |
| 1164809802 | Community Care of West Virginia, Inc. | Clinic/Center | 2 Mountaineer Dr, Clarksburg, WV 26301-5511 | 2015-05-01 |
| 1346636792 | Community Care of West Virginia, Inc. | Clinic/Center | 1400 N 19th St, Clarksburg, WV 26301-1644 | 2015-04-13 |
| 1851787121 | Community Care of West Virginia Inc | Clinic/Center | 1636 W Pike St, Clarksburg, WV 26301-2361 | 2015-04-13 |
| 1194111468 | Community Care of West Virginia, Inc. | Clinic/Center | 1 Mountaineer Dr, Clarksburg, WV 26301-5511 | 2015-04-13 |
| 1538555891 | Community Care of West Virginia, Inc. | Clinic/Center | 1040 Wilsonburg Rd, Clarksburg, WV 26301-6511 | 2015-04-13 |
| 1356780639 | Community Care of West Virginia, Inc. | Clinic/Center | 1 Eagle Way, Clarksburg, WV 26301-9784 | 2013-06-19 |
| 1619316999 | Community Care of West Virginia, Inc. | Clinic/Center | 443 Lee Ave, Clarksburg, WV 26301-3648 | 2013-06-19 |
| 1053742668 | Community Care of West Virginia, Inc. | Clinic/Center | 700 Oakmound Rd, Clarksburg, WV 26301-9398 | 2013-12-06 |
| Find all providers in CLARKSBURG | ||||
| City | CLARKSBURG |
| Zip Code | 15725 |
Please comment or provide details below to improve the information on PRIMARY HEALTH NETWORK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.