Provider Demographics
NPI:1790783009
Name:UNITED MEDICAL SERVICES INC.
Entity Type:Organization
Organization Name:UNITED MEDICAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-339-7185
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63702-0326
Mailing Address - Country:US
Mailing Address - Phone:573-339-7185
Mailing Address - Fax:573-339-1079
Practice Address - Street 1:319 S SILVER SPRINGS RD
Practice Address - Street 2:STE A
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-6308
Practice Address - Country:US
Practice Address - Phone:573-339-7185
Practice Address - Fax:573-339-1079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
121789OtherBCBS
MO504748401Medicaid
000013106Medicare ID - Type Unspecified