1306913736 NPI number — UHS OF LAUREL HEIGHTS, LP

Table of content: (NPI 1306913736)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306913736 NPI number — UHS OF LAUREL HEIGHTS, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UHS OF LAUREL HEIGHTS, 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:
LAUREL HEIGHTS
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:
1306913736
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
934 BRIARCLIFF RD NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30306-2618
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-888-7860
Provider Business Mailing Address Fax Number:
404-872-5088

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
934 BRIARCLIFF RD NE
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:
30306-2618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-888-7860
Provider Business Practice Location Address Fax Number:
404-872-5088
Provider Enumeration Date:
11/29/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FILTON
Authorized Official First Name:
STEVE
Authorized Official Middle Name:
Authorized Official Title or Position:
SR VP CFO
Authorized Official Telephone Number:
610-768-3300

Provider Taxonomy Codes

  • Taxonomy code: 283Q00000X , with the licence number:  044694 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 323P00000X , with the licence number: 044588 , 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)

  • Identifier: 00651593A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 118679600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".