Provider Demographics
NPI:1518003300
Name:UNITED HEALTH SERVICES HOSPITALS, INC.
Entity Type:Organization
Organization Name:UNITED HEALTH SERVICES HOSPITALS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP,FISCAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:GOMULKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-762-3006
Mailing Address - Street 1:PO BOX 5214
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13902-5214
Mailing Address - Country:US
Mailing Address - Phone:607-762-3027
Mailing Address - Fax:607-762-2065
Practice Address - Street 1:20-42 MITCHELL AVENUE
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903
Practice Address - Country:US
Practice Address - Phone:607-762-3027
Practice Address - Fax:607-762-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY33Z394OtherEXCELLUS-BRAIN INJURY UNI
NY33V394OtherEXCELLUS-ARU