Provider Demographics
NPI:1891882049
Name:UNIVERSITY OF NORTH CAROLINA
Entity Type:Organization
Organization Name:UNIVERSITY OF NORTH CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED ATHLETIC TRAINER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:CROWELL
Authorized Official - Suffix:
Authorized Official - Credentials:ATC, LAT
Authorized Official - Phone:919-962-8519
Mailing Address - Street 1:710 SPRING MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7196
Mailing Address - Country:US
Mailing Address - Phone:919-966-6548
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:CAMPUS HEALTH SERVICE
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-6548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0307261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0307OtherSTATE LICENSURE