Provider Demographics
NPI:1801172945
Name:UNITY FAMILY HEALTHCARE PHYSICIAN SERVICES
Entity type:Organization
Organization Name:UNITY FAMILY HEALTHCARE PHYSICIAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-631-5670
Mailing Address - Street 1:811 2ND SE ST.
Mailing Address - Street 2:STE A
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-3505
Mailing Address - Country:US
Mailing Address - Phone:320-631-7200
Mailing Address - Fax:320-632-0534
Practice Address - Street 1:811 2ND SE ST.
Practice Address - Street 2:STE A
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-3505
Practice Address - Country:US
Practice Address - Phone:320-631-7200
Practice Address - Fax:320-632-0534
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITY FAMILY HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty