Provider Demographics
NPI:1851416721
Name:UNITED HEALTH SERVICES HPSOITALS, INC
Entity Type:Organization
Organization Name:UNITED HEALTH SERVICES HPSOITALS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO FISCAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:GOMULKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-762-3006
Mailing Address - Street 1:20 MITCHELL AVE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13903
Mailing Address - Country:US
Mailing Address - Phone:607-762-3027
Mailing Address - Fax:607-762-2065
Practice Address - Street 1:20 MITCHELL AVE
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903
Practice Address - Country:US
Practice Address - Phone:607-762-3027
Practice Address - Fax:607-762-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0303001H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY335851Medicare ID - Type UnspecifiedTCU DEMONSTRATION PROJECT