Schuylkill Medical Center - South Jackson Street
Psychiatry & Neurology, Psychiatry in Pottsville, PA. Organization (NPI-2).
NPI number1982606802
StatusActive
Last updated in NPPESJul 16, 2013
Details
- NPI
- 1982606802
- Entity type
- Organization (NPI-2)
- Legal business name
- Schuylkill Medical Center - South Jackson Street
- Organization subpart
- No
- Enumeration date
- Aug 11, 2005
- Last updated
- Jul 16, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | Yes |
Other names
- Schuylkill Medical Center - South Jackson Street Psychiatry Group (Doing Business As)
Practice location
420 S Jackson StPottsville, PA 17901-3625
Phone 570-621-5000 · Fax 570-622-8221
Mailing address
420 S Jackson StPottsville, PA 17901-3625
Phone 570-621-5000 · Fax 570-622-8221
Authorized official
John E. Simodejka
President And Ceo
5706215111
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