Provider Demographics
NPI:1912303223
Name:UNIVERSITY ORTHOPEDICS CENTER, LTD
Entity Type:Organization
Organization Name:UNIVERSITY ORTHOPEDICS CENTER, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAVIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-231-2101
Mailing Address - Street 1:101 REGENT CT
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7965
Mailing Address - Country:US
Mailing Address - Phone:814-231-2101
Mailing Address - Fax:814-231-8569
Practice Address - Street 1:90 BEAVER DR STE 211D
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2449
Practice Address - Country:US
Practice Address - Phone:800-505-2101
Practice Address - Fax:814-231-8569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-13
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0694150001Medicare NSC