Provider Demographics
NPI:1376522821
Name:APPALACHIAN STATE UNIVERSITY STUDENT HEALTH SERVICES
Entity Type:Organization
Organization Name:APPALACHIAN STATE UNIVERSITY STUDENT HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GEIGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-262-3100
Mailing Address - Street 1:PO BOX 32070
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28608-2070
Mailing Address - Country:US
Mailing Address - Phone:828-262-3100
Mailing Address - Fax:828-262-6262
Practice Address - Street 1:614 HOWARD STREET
Practice Address - Street 2:BOX 32070
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28608-0001
Practice Address - Country:US
Practice Address - Phone:828-262-3100
Practice Address - Fax:828-262-6262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0200553261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health