Organization
GROVE CITY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JACKSON JR. (CEO)
(724) 450-7197
Entity
Organization
Contact information
Practice address
631 N BROAD STREET EXT, GROVE CITY, PA 16127-4603
(724) 450-7000
Mailing address
631 N BROAD STREET EXT, GROVE CITY, PA 16127-4603
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
210801
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007765470020
—
PA
Enumeration date
12/22/2006
Last updated
07/29/2008
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