Healthcare Provider Details

I. General information

NPI: 1790932051
Provider Name (Legal Business Name): UNIVERSITY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 INFIRMARY WAY
AMHERST MA
01003-9288
US

IV. Provider business mailing address

150 INFIRMARY WAY
AMHERST MA
01003-9288
US

V. Phone/Fax

Practice location:
  • Phone: 413-577-5007
  • Fax:
Mailing address:
  • Phone: 413-577-5007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number5004
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. DONNS M SIMS
Title or Position: OPTICIAN
Credential: RDO
Phone: 413-577-5007