Provider Demographics
NPI:1851320766
Name:MILLERSVILLE UNIVERSITY HEALTH SERVICES
Entity Type:Organization
Organization Name:MILLERSVILLE UNIVERSITY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HEFFERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-872-3250
Mailing Address - Street 1:PO BOX 1002
Mailing Address - Street 2:HEALTH SERVICES
Mailing Address - City:MILLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17551-0302
Mailing Address - Country:US
Mailing Address - Phone:717-872-3250
Mailing Address - Fax:717-871-2344
Practice Address - Street 1:4 MCCULLOUGH STREET
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17551-0302
Practice Address - Country:US
Practice Address - Phone:717-872-3250
Practice Address - Fax:717-871-2344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health