Healthcare Provider Details

I. General information

NPI: 1740837806
Provider Name (Legal Business Name): UNITED HEALTH SERVICES HOSPITALS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2019
Last Update Date: 03/26/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 MAIN ST STE A
JOHNSON CITY NY
13790-2050
US

IV. Provider business mailing address

345 MAIN ST STE A
JOHNSON CITY NY
13790-2050
US

V. Phone/Fax

Practice location:
  • Phone: 607-352-5948
  • Fax: 607-352-5949
Mailing address:
  • Phone: 607-352-5948
  • Fax: 607-352-5949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM G WALDRON
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 607-763-1835