Provider Demographics
NPI:1457482952
Name:ANDERSON UNIVERSITY
Entity Type:Organization
Organization Name:ANDERSON UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVANS
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-231-2100
Mailing Address - Street 1:316 BOULEVARD
Mailing Address - Street 2:BOX 997
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-4002
Mailing Address - Country:US
Mailing Address - Phone:864-231-2144
Mailing Address - Fax:864-622-6059
Practice Address - Street 1:200 GEORGE B TIMMERMAN DR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1802
Practice Address - Country:US
Practice Address - Phone:864-261-3658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6442255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty