Provider Demographics
NPI:1841457629
Name:UNIVERSITY HEALTH SERVICES PC, LLC
Entity type:Organization
Organization Name:UNIVERSITY HEALTH SERVICES PC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:D
Authorized Official - Last Name:DENZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:970-391-0002
Mailing Address - Street 1:UNC HEALTH CTR
Mailing Address - Street 2:CASSIDY HALL - CAMPUS BOX 37
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80639-0001
Mailing Address - Country:US
Mailing Address - Phone:970-351-2412
Mailing Address - Fax:
Practice Address - Street 1:1901 10TH AVE
Practice Address - Street 2:UNC HEALTH CENTER - CASSIDY HALL
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80639-5545
Practice Address - Country:US
Practice Address - Phone:970-351-2412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32068207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01320688Medicaid
COE96507Medicare UPIN
COC498038Medicare PIN