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Organization
GROVE CITY MEDICAL CENTER
Active
Organization
GROVE CITY MEDICAL CENTER
Active
Other names
GCMC Pain Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT C JACKSON JR. (CHIEF EXECUTIVE OFFICER)
(724) 450-7197
Entity
Organization
Contact information
Practice address
631 N BROAD STREET EXT, GROVE CITY, PA 16127-4603
(724) 450-7000
(724) 450-7013
Mailing address
631 N. BROAD STREET EXT., GROVE CITY, PA 16127-4603
(724) 450-7000
(724) 450-7013
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
OS005324L
PA
208VP0000X
Pain Medicine Physician
OS005324L
PA
Other
Enumeration date
08/02/2017
Last updated
08/02/2017
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