Provider Demographics
NPI:1396001616
Name:THE UNIVERSITY OF NORTH CAROLINA AT GREENSBORO
Entity Type:Organization
Organization Name:THE UNIVERSITY OF NORTH CAROLINA AT GREENSBORO
Other - Org Name:STUDENT HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TRESA
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:SAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MPH
Authorized Official - Phone:336-334-3134
Mailing Address - Street 1:107 GRAY DR
Mailing Address - Street 2:GOVE STUDENT HEALTH CENTER
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27412-5008
Mailing Address - Country:US
Mailing Address - Phone:336-334-3130
Mailing Address - Fax:336-334-3299
Practice Address - Street 1:107 GRAY DR
Practice Address - Street 2:GOVE STUDENT HEALTH CENTER
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27412-5008
Practice Address - Country:US
Practice Address - Phone:336-334-3130
Practice Address - Fax:336-334-3299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service