1427239169 NPI number — UNIVERSITY MEDICAL SERVICES & SUPPL

Table of content: DR. HECTOR URIEL LOPEZ M.D. (NPI 1043494032)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427239169 NPI number — UNIVERSITY MEDICAL SERVICES & SUPPL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY MEDICAL SERVICES & SUPPL
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:
1427239169
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2734
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST COLUMBIA
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29171-2734
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-319-1805
Provider Business Mailing Address Fax Number:
803-796-9320

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6941 NORTH TRENHOLM ROAD SUITE 0-103
Provider Second Line Business Practice Location Address:
PINNACLE PROFESSIONAL PARK
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29206-1729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-782-0761
Provider Business Practice Location Address Fax Number:
803-782-0762
Provider Enumeration Date:
11/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCFARLIN
Authorized Official First Name:
ALFRED
Authorized Official Middle Name:
WILLIAM
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
803-319-1805

Provider Taxonomy Codes

  • Taxonomy code: 332BN1400X , with the licence number:  040 70930 4 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: DE3099 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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