NPIMap

Organization Active NPI

Primary Health Services Center

Doing business as PHSC Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Monroe, LA
National Provider Identifier
1053604892
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PRIMARY HEALTH SERVICES CENTER
Doing business as
PHSC Dental Clinic
Practice address
2914 Betin Ave
Monroe, LA 71201-7258
Phone
(318) 323-4450
Fax
(318) 323-4430
NPI assigned
May 26, 2011
Last updated
Apr 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Catherine M Tonore
Title
Ceo
Phone
(318) 388-1250

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2914 Betin Ave
Monroe, LA 71201-7258

Mailing address

PO Box 7495
Monroe, LA 71211-7495
Phone (318) 388-1250

Other identifiers 1

IdentifierTypeStateIssuer
2177427MedicaidLA

Other names 1

  • PHSC Dental Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Primary Health Services Ctr8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2914 Betin Ave
Monroe, LA 71201
Phone (318) 323-4450

301 McMillan Rd
West Monroe, LA 71291
Phone (318) 322-2332

388 S Main St
Marion, OH 43302
Phone (740) 387-9535

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618444800000",
    "number": "1053604892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7495",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712117495",
            "telephone_number": "318-388-1250",
            "fax_number": "318-388-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2914 BETIN AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017258",
            "telephone_number": "318-323-4450",
            "fax_number": "318-323-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY HEALTH SERVICES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A",
        "authorized_official_last_name": "TONORE",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-388-1250",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2177427",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHSC Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.