| Schuylkill Medical Center - South Jackson Street Psychiatry Group | |
|
420 S Jackson St Pottsville PA 17901-3625 | |
| (570) 621-5000 | |
| (570) 622-8221 |
| Full Name | Schuylkill Medical Center - South Jackson Street Psychiatry Group |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 420 S Jackson St, Pottsville, Pennsylvania |
| Authorized Official Name and Position | John E. Simodejka (PRESIDENT AND CEO) |
| Authorized Official Contact | 5706215111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Schuylkill Medical Center - South Jackson Street Psychiatry Group 420 S Jackson St Pottsville PA 17901-3625 Ph: (570) 621-5000 | Schuylkill Medical Center - South Jackson Street Psychiatry Group 420 S Jackson St Pottsville PA 17901-3625 Ph: (570) 621-5000 |
| NPI Number | 1982606802 |
|---|---|
| Provider Enumeration Date | 08/11/2005 |
| Last Update Date | 07/16/2013 |
| Medicare PECOS PAC ID | 4183525959 |
|---|---|
| Medicare Enrollment ID | O20040408001006 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982606802 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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