Healthcare Provider Details

I. General information

NPI: 1699104844
Provider Name (Legal Business Name): UNION MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2013
Last Update Date: 10/27/2021
Certification Date: 10/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 DALE EARNHARDT BLVD SUITE 100
KANNAPOLIS NC
28081-0303
US

IV. Provider business mailing address

201 DALE EARNHARDT BLVD SUITE 100
KANNAPOLIS NC
28081-0303
US

V. Phone/Fax

Practice location:
  • Phone: 704-403-7406
  • Fax: 704-403-7548
Mailing address:
  • Phone: 704-403-7406
  • Fax: 704-403-7548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: JOHN KREPSHAW
Title or Position: VP RADIOLOGY
Credential:
Phone: 704-362-5391