1881782548 NPI number — UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL

Table of content: (NPI 1881782548)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881782548 NPI number — UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
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:
6
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:
1881782548
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
325 RUSSET RUN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27312-5000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-542-1910
Provider Business Mailing Address Fax Number:
919-542-0978

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
325 RUSSET RUN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27312-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-542-1910
Provider Business Practice Location Address Fax Number:
919-542-0978
Provider Enumeration Date:
10/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MANN
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
VICE CHANCELLOR FINANCE & ADMIN
Authorized Official Telephone Number:
919-962-3798

Provider Taxonomy Codes

  • Taxonomy code: 320600000X , with the licence number:  MHL019007 , 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: 27G.5600C . This is a "SRVCS-SPVLIVDDADLT ICF-MR" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: MHL-019-007 . This is a "LICENSE NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 921564 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 27G.2300 . This is a "SERVICE CODE-ADVP ICF/MR" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 3406187 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: GM4 . This is a "DSS FACILITY CODE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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