Provider Demographics
NPI:1073039657
Name:UNIVERSITY ORTHOPEDICS, INC.
Entity Type:Organization
Organization Name:UNIVERSITY ORTHOPEDICS, INC.
Other - Org Name:UOI-EAST BAY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WEBER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHILL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:401-457-1504
Mailing Address - Street 1:PO BOX 1119
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02901-1119
Mailing Address - Country:US
Mailing Address - Phone:401-443-4150
Mailing Address - Fax:
Practice Address - Street 1:1 KETTLE POINT AVE STE 200
Practice Address - Street 2:
Practice Address - City:E PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-5375
Practice Address - Country:US
Practice Address - Phone:401-443-4230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical