1891007506 NPI number — UNIVERSAL HEALTH CARE/NASHVILLE, INC

Table of content: (NPI 1891007506)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891007506 NPI number — UNIVERSAL HEALTH CARE/NASHVILLE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSAL HEALTH CARE/NASHVILLE, INC
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:
Provider Other Organization Name Type Code:
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:
1891007506
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/10/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 10TH ST NW
Provider Second Line Business Mailing Address:
SUITE B-2
Provider Business Mailing Address City Name:
CONOVER
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28613-2419
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-464-1817
Provider Business Mailing Address Fax Number:
828-464-8137

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1022 EASTERN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27856-1718
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-459-3014
Provider Business Practice Location Address Fax Number:
252-459-5092
Provider Enumeration Date:
07/10/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WHITE
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
SUTTON
Authorized Official Title or Position:
A/R DIRECTOR
Authorized Official Telephone Number:
828-464-1817

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  NH0500 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3425374 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7801835 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".