1124207220 NPI number — UHS OF PEACHFORD LP

Table of content: (NPI 1124207220)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124207220 NPI number — UHS OF PEACHFORD LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UHS OF PEACHFORD LP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PEACHFORD BEHAVIORAL HEALTH SYSTEM OF ATLANTA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124207220
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/27/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
367 S GULPH RD
Provider Second Line Business Mailing Address:
ATTN. PATTI JONES
Provider Business Mailing Address City Name:
KING OF PRUSSIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19406-3121
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-768-3359
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2151 PEACHFORD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30338-6534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-455-3200
Provider Business Practice Location Address Fax Number:
770-454-2349
Provider Enumeration Date:
10/25/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FILTON
Authorized Official First Name:
STEVE
Authorized Official Middle Name:
Authorized Official Title or Position:
SVP
Authorized Official Telephone Number:
800-347-7750

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  044-596 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)