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General NPI Number Information
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NPI Number | 1972532109
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Entity Type | Organization
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Legal Business Name | GREENE COUNTY PRIMARY CARE, PC
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 430 E OAKVIEW DR SUITE A
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City | WAYNESBURG
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State | PA
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Zip | 15370-9729
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Country | US
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Telephone | 724-627-8582
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Fax | 724-627-7756
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Provider Business Mailing Address
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Address Line | 430 E OAKVIEW DR SUITE A
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City | WAYNESBURG
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State | PA
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Zip | 15370-9729
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Country | US
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Telephone | 724-627-8582
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Fax | 724-627-7756
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMI D BORIS
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Credential | MD
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Telephone | 724-627-8582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD418743
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD418743
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License Number State | PA
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