Provider Demographics
NPI:1710227194
Name:UNIVERSAL HEALTHCARE MANAGEMENT SERVICES, INC
Entity Type:Organization
Organization Name:UNIVERSAL HEALTHCARE MANAGEMENT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-735-1165
Mailing Address - Street 1:2810 WALTERS LN
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-3247
Mailing Address - Country:US
Mailing Address - Phone:301-735-1635
Mailing Address - Fax:
Practice Address - Street 1:2810 WALTERS LN
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-3247
Practice Address - Country:US
Practice Address - Phone:301-735-1635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC036395200Medicaid