1366403784 NPI number — UNIVERSITY HEALTH CARE

Table of content: (NPI 1366403784)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366403784 NPI number — UNIVERSITY HEALTH CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY HEALTH CARE
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:
PERINATAL PATIENT EDUCATION
Provider Other Organization Name Type Code:
5
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:
1366403784
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 N MEDICAL DR
Provider Second Line Business Mailing Address:
ROOM AA 119
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84132-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-581-2328
Provider Business Mailing Address Fax Number:
801-585-3487

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 N MEDICAL DR
Provider Second Line Business Practice Location Address:
ROOM AA 119
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84132-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-581-2328
Provider Business Practice Location Address Fax Number:
801-585-3487
Provider Enumeration Date:
03/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
KIRTS
Authorized Official Title or Position:
PATIENT CARE COORDINATOR
Authorized Official Telephone Number:
807-581-2896

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: S9446 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com