Provider Demographics
NPI:1720374044
Name:UNIVERSITY HOSPITAL & CLINICS
Entity Type:Organization
Organization Name:UNIVERSITY HOSPITAL & CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENCY COORDINATOR - NEUROLOGY
Authorized Official - Prefix:
Authorized Official - First Name:ANNAMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFE-BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-882-2260
Mailing Address - Street 1:1 HOSPITAL DR # DC047.00
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-5276
Mailing Address - Country:US
Mailing Address - Phone:573-882-2260
Mailing Address - Fax:573-884-4249
Practice Address - Street 1:1 HOSPITAL DR # DC047.00
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-5276
Practice Address - Country:US
Practice Address - Phone:573-882-2260
Practice Address - Fax:573-884-4249
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY HOSPITAL & CLINICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011017409282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital