Provider Demographics
NPI:1437459617
Name:UNION HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:UNION HEALTH SERVICES, LLC
Other - Org Name:ATRIUM HEALTH SURGERY CENTER INDIAN TRAIL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-821-5192
Mailing Address - Street 1:6068 W HIGHWAY 74
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-3591
Mailing Address - Country:US
Mailing Address - Phone:704-821-5192
Mailing Address - Fax:704-821-5193
Practice Address - Street 1:6068 W HIGHWAY 74
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-3591
Practice Address - Country:US
Practice Address - Phone:704-821-5192
Practice Address - Fax:704-821-5193
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNION MEMORIAL REGIONAL MEDICAL CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-22
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCAS0132OtherSTATE LICENSE