Provider Demographics
NPI:1851732507
Name:UNITED MEDICAL SERVICES
Entity Type:Organization
Organization Name:UNITED MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-364-8005
Mailing Address - Street 1:3125 ASHLEY PHOSPHATE RD
Mailing Address - Street 2:SUITE 114A
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-8417
Mailing Address - Country:US
Mailing Address - Phone:843-360-8005
Mailing Address - Fax:
Practice Address - Street 1:3125 ASHLEY PHOSPHATE RD
Practice Address - Street 2:SUITE 114A
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-8417
Practice Address - Country:US
Practice Address - Phone:843-360-8005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11629207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty