Provider Demographics
NPI:1326153685
Name:JABBOUR MEDICAL CENTER
Entity Type:Organization
Organization Name:JABBOUR MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:JABBOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-832-9378
Mailing Address - Street 1:337 HARVEY AVE # A
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-1994
Mailing Address - Country:US
Mailing Address - Phone:724-832-9378
Mailing Address - Fax:724-832-9384
Practice Address - Street 1:337 HARVEY AVE # A
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1994
Practice Address - Country:US
Practice Address - Phone:724-832-9378
Practice Address - Fax:724-832-9384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2007-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010467010004Medicaid
PA421466Medicare ID - Type Unspecified