Organization
GREENVILLE MEDICAL CENTER
Active
Organization
GREENVILLE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THORA R JACKSON (ADMINISTRATOR)
(724) 589-4300
Entity
Organization
Contact information
Practice address
90 SHENANGO ST, GREENVILLE, PA 16125-2060
(724) 588-4240
(724) 588-0198
Mailing address
90 SHENANGO ST, GREENVILLE, PA 16125-2060
(724) 588-4240
(724) 588-0198
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2085B0100X
Body Imaging Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006509810001
—
PA
Enumeration date
03/14/2006
Last updated
09/11/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up