Healthcare Provider Details

I. General information

NPI: 1124487723
Provider Name (Legal Business Name): UNIVERSITY ORTHOPEDICS CENTER, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2016
Last Update Date: 02/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 JUNE DR
ROARING SPRING PA
16673-1209
US

IV. Provider business mailing address

101 REGENT CT
STATE COLLEGE PA
16801-7965
US

V. Phone/Fax

Practice location:
  • Phone: 814-231-2101
  • Fax:
Mailing address:
  • Phone: 841-231-2101
  • Fax: 814-231-8569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DAVID J DAVIES
Title or Position: CEO
Credential:
Phone: 814-272-3671