MEDICARE: UNIVERSITY HEALTH SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HHA-137	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	6659	OTHER		JCAHO

General Provider Information

NPI Number	:	1457309676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	106B E MARTINTOWN RD
Second Line	:
City	:	NORTH AUGUSTA
State	:	SC
Zip	:	29841-3425
Country	:	US
Telephone Number	:	803-278-0770
Fax Number	:	803-278-0771

Provider Business Practice Location Address
First Line	:	106B E MARTINTOWN RD
Second Line	:
City	:	NORTH AUGUSTA
State	:	SC
Zip	:	29841-3425
Country	:	US
Telephone Number	:	803-278-0770
Fax Number	:	803-278-0771

Authorized Official
Title or Position	:	EXEC VP/COO
Name	:	MR. JASON MOORE
Credential	:
Telephone Number	:	706-722-9011

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	08/22/2020

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