Provider Demographics
NPI:1588665566
Name:UNIVERSITY HEALTH SERVICES,INC
Entity Type:Organization
Organization Name:UNIVERSITY HEALTH SERVICES,INC
Other - Org Name:UNIVERSITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, GOVERNMENT REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-271-3402
Mailing Address - Street 1:1350 WALTON WAY
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2612
Mailing Address - Country:US
Mailing Address - Phone:706-722-9011
Mailing Address - Fax:706-828-2524
Practice Address - Street 1:1350 WALTON WAY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2612
Practice Address - Country:US
Practice Address - Phone:706-828-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-02
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC150241Medicaid
GA000001977AMedicaid
SC230172Medicaid