Provider Demographics
NPI:1013017078
Name:UVPC SPECIALISTS, INC.
Entity Type:Organization
Organization Name:UVPC SPECIALISTS, INC.
Other - Org Name:UPPER VALLEY WOMEN'S CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:RADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-440-7454
Mailing Address - Street 1:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-0425
Mailing Address - Country:US
Mailing Address - Phone:937-773-0428
Mailing Address - Fax:937-773-0439
Practice Address - Street 1:450 N HYATT ST
Practice Address - Street 2:SUITE 206
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-1433
Practice Address - Country:US
Practice Address - Phone:937-773-0428
Practice Address - Fax:937-773-0439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2718509Medicaid
OH2718509Medicaid