Provider Demographics
NPI:1164094223
Name:PAIN MEDICINE VI, PLLC
Entity Type:Organization
Organization Name:PAIN MEDICINE VI, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:M
Authorized Official - Last Name:GOLOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-493-9449
Mailing Address - Street 1:4003 BESTON HILL MEDICAL
Mailing Address - Street 2:STE 4
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820
Mailing Address - Country:US
Mailing Address - Phone:340-474-9440
Mailing Address - Fax:954-493-8889
Practice Address - Street 1:4003 BESTON HILL MEDICAL
Practice Address - Street 2:STE 4
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820
Practice Address - Country:US
Practice Address - Phone:340-474-9440
Practice Address - Fax:954-493-8889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-16
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty