Provider Demographics
NPI:1912952557
Name:THE PAIN CENTER, INC.
Entity type:Organization
Organization Name:THE PAIN CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTH REP
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-979-6595
Mailing Address - Street 1:109 MOUNT WOOD RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-2632
Mailing Address - Country:US
Mailing Address - Phone:304-797-6595
Mailing Address - Fax:304-797-6052
Practice Address - Street 1:651 COLLIERS WAY STE 510
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-5054
Practice Address - Country:US
Practice Address - Phone:304-797-6595
Practice Address - Fax:304-797-6052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVCJ0334OtherRAIL ROAD MEDICARE
WVCJ0334OtherRAIL ROAD MEDICARE