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General NPI Number Information
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NPI Number | 1932157450
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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 | 05/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4106 COLUMBIA RD SUITE 101
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City | MARTINEZ
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State | GA
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Zip | 30907-1450
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Country | US
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Telephone | 706-868-3220
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Fax | 706-868-3221
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Provider Business Mailing Address
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Address Line | 4106 COLUMBIA RD SUITE 101
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City | MARTINEZ
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State | GA
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Zip | 30907-1450
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Country | US
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Telephone | 706-868-3220
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Fax | 706-868-3221
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Authorized Official
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Title or Position | EXEC VP/COO
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Name | MR. JASON MOORE
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Credential |
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Telephone | 706-722-9011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 036-R-0002
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License Number State | GA
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