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General NPI Number Information
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NPI Number | 1699102590
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Entity Type | Organization
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Legal Business Name | UNIVERSITY HEALTH SERVICES, INC
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Dates
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Enumeration Date | 10/09/2013
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Last Update Date | 10/14/2013
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Provider Practice Location Address
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Address Line | 1350 WALTON WAY
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City | AUGUSTA
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State | GA
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Zip | 30901-2612
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Country | US
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Telephone | 706-774-5401
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Fax | 706-774-7991
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Provider Business Mailing Address
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Address Line | 1350 WALTON WAY
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City | AUGUSTA
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State | GA
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Zip | 30901-2612
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Country | US
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Telephone | 706-774-5401
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Fax | 706-774-7991
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Authorized Official
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Title or Position | DIRECTOR, LABORATORY
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Name | MRS. CHRISTA PARDUE
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Credential | MT (AMT) MBA
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Telephone | 706-774-5401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 121-010
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License Number State | GA
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