Provider Demographics
NPI:1851398408
Name:CENTER FOR PAIN CONTROL, PC
Entity Type:Organization
Organization Name:CENTER FOR PAIN CONTROL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-374-2927
Mailing Address - Street 1:1235 PENN AVE
Mailing Address - Street 2:STE 302
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-2100
Mailing Address - Country:US
Mailing Address - Phone:610-374-2927
Mailing Address - Fax:610-374-2909
Practice Address - Street 1:1235 PENN AVE
Practice Address - Street 2:STE 302
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2100
Practice Address - Country:US
Practice Address - Phone:610-374-2927
Practice Address - Fax:610-374-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACE065275Medicare ID - Type Unspecified