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General NPI Number Information
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NPI Number | 1902874142
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Entity Type | Organization
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Legal Business Name | GREENVILLE MEDICAL CENTER
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 90 SHENANGO ST
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City | GREENVILLE
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State | PA
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Zip | 16125-2060
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Country | US
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Telephone | 724-588-4240
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Fax | 724-588-0198
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Provider Business Mailing Address
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Address Line | 90 SHENANGO ST
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City | GREENVILLE
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State | PA
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Zip | 16125-2060
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Country | US
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Telephone | 724-588-4240
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Fax | 724-588-0198
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | THORA R JACKSON
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Credential |
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Telephone | 724-589-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number |
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License Number State |
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