Provider Demographics
NPI:1619114469
Name:UNIVERSAL HEALTH SYSTEMS INC
Entity Type:Organization
Organization Name:UNIVERSAL HEALTH SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NKEM
Authorized Official - Middle Name:D
Authorized Official - Last Name:OLANREWAJU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-355-5272
Mailing Address - Street 1:4 PROFESSIONAL DR
Mailing Address - Street 2:SUITE 149
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3407
Mailing Address - Country:US
Mailing Address - Phone:301-355-5272
Mailing Address - Fax:301-355-5273
Practice Address - Street 1:4 PROFESSIONAL DR
Practice Address - Street 2:SUITE 149
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3407
Practice Address - Country:US
Practice Address - Phone:301-355-5272
Practice Address - Fax:301-355-5273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2619251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD8046026-00Medicaid
MD8046034-00Medicaid