Provider Demographics
NPI:1770535874
Name:UNIVERSAL MOBILE SERVICES, INC.
Entity type:Organization
Organization Name:UNIVERSAL MOBILE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:G
Authorized Official - Last Name:AUTIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-374-7971
Mailing Address - Street 1:12 ROGERS RD
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01835-6925
Mailing Address - Country:US
Mailing Address - Phone:978-374-7971
Mailing Address - Fax:978-374-8354
Practice Address - Street 1:12 ROGERS RD
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01835-6925
Practice Address - Country:US
Practice Address - Phone:978-374-7971
Practice Address - Fax:978-374-8354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30210858Medicaid
MA9784292Medicaid
MA9784292Medicaid