Healthcare Provider Details

I. General information

NPI: 1548907942
Provider Name (Legal Business Name): HPU HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 05/17/2022
Certification Date: 05/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 UNIVERSITY PKWY
HIGH POINT NC
27268-0002
US

IV. Provider business mailing address

1 UNIVERSITY PKWY
HIGH POINT NC
27268-0002
US

V. Phone/Fax

Practice location:
  • Phone: 336-439-4365
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code125Q00000X
TaxonomyOral Medicine Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEBORAH SHUTTERS
Title or Position: VP FOR FINANCIAL AFFAIRS, CFO, MEMB
Credential:
Phone: 336-841-9202