Organization Name:  GREENVILLE MEDICAL CENTER


Practice Location:
90 SHENANGO ST  GREENVILLE, PA 16125 US
Tel: 724-588-4240  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
X	207K00000X	Physicians Allergy & Immunology
X	207Q00000X	Physicians Family Medicine
X	207R00000X	Physicians Internal Medicine
X	207RH0003X	Physicians Internal Medicine
X	207V00000X	Physicians Obstetrics & Gynecology
X	208000000X	Physicians Pediatrics
X	2085B0100X	Physicians Radiology

Other Provider Identifiers:

Issuer	Number	State	Type
	0006509810001	PA	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin