MEDICARE: UNIVERSITY HEALTH SERVICES

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	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1891961033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY HEALTH SERVICES

Provider Business Mailing Address
First Line	:	100 MORRISSEY BLVD
Second Line	:	QUINN ADMINISTRATION BUILDING HEALTH SERVICES
City	:	BOSTON
State	:	MA
Zip	:	02125-3393
Country	:	US
Telephone Number	:	617-287-5660
Fax Number	:	617-287-3977

Provider Business Practice Location Address
First Line	:	100 MORRISSEY BLVD
Second Line	:	QUINN ADMINISTRATION BUILDING HEALTH SERVICES
City	:	BOSTON
State	:	MA
Zip	:	02125-3393
Country	:	US
Telephone Number	:	617-287-5660
Fax Number	:	617-287-3977

Authorized Official
Title or Position	:	EXEC DIR ASST VICE CHANCELLOR
Name	:	KATHLEEN GOLDEN MCANDREW
Credential	:	MSN ANP FAAOHN FAANP
Telephone Number	:	617-287-5666

Provider Enumeration Date	:	05/07/2008
Last Update Date	:	05/07/2008

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Directions to “UNIVERSITY HEALTH SERVICES ” Practice Location

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