Healthcare Provider Details

I. General information

NPI: 1184616815
Provider Name (Legal Business Name): GROVE CITY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 N BROAD STREET EXT
GROVE CITY PA
16127-4603
US

IV. Provider business mailing address

631 N BROAD STREET EXT
GROVE CITY PA
16127-4603
US

V. Phone/Fax

Practice location:
  • Phone: 724-450-7066
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number745105
License Number StatePA

VIII. Authorized Official

Name: KAREN GREGG
Title or Position: DIRECTOR, HOME HEALTH
Credential:
Phone: 724-450-7066