Provider Demographics
NPI:1891961033
Name:UNIVERSITY HEALTH SERVICES
Entity Type:Organization
Organization Name:UNIVERSITY HEALTH SERVICES
Other - Org Name:UNIVERSITY HEALTH SERVICES UNIVERSITY OF MASSACHUSETTS BOSTON
Other - Org Type:Other Name
Authorized Official - Title/Position:EXEC DIR ASST VICE CHANCELLOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDEN MCANDREW
Authorized Official - Suffix:
Authorized Official - Credentials:MSN ANP FAAOHN FAANP
Authorized Official - Phone:617-287-5666
Mailing Address - Street 1:100 MORRISSEY BLVD
Mailing Address - Street 2:QUINN ADMINISTRATION BUILDING HEALTH SERVICES
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02125-3393
Mailing Address - Country:US
Mailing Address - Phone:617-287-5660
Mailing Address - Fax:617-287-3977
Practice Address - Street 1:100 MORRISSEY BLVD
Practice Address - Street 2:QUINN ADMINISTRATION BUILDING HEALTH SERVICES
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02125-3393
Practice Address - Country:US
Practice Address - Phone:617-287-5660
Practice Address - Fax:617-287-3977
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF MASSACHUSETTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service