1467697953 NPI number — UNIVERSITY COMMUNITY HOSPITAL, INC

Table of content: (NPI 1467697953)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467697953 NPI number — UNIVERSITY COMMUNITY HOSPITAL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY COMMUNITY HOSPITAL, 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:
FLORIDA HOSPITAL AT CONNERTON LONG TERM ACUTE CARE HOSPITAL
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:
1467697953
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4714 GETTYSBURG RD
Provider Second Line Business Mailing Address:
LEGAL DEPARTMENT
Provider Business Mailing Address City Name:
MECHANICSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17055-4325
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-972-1100
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9441 HEALTH CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAND O LAKES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34637-5837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-787-5822
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIS
Authorized Official First Name:
RYAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
813-779-6201

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X , with the licence number:  4499 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000949600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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