Basic Information
| Provider Information | |||||||||
| NPI: | 1912335258 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNITED HEALTHCARE SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2111 VAN DEMAN ST | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212246609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4438960710 | ||||||||
| FaxNumber: | 6123670841 | ||||||||
| Practice Location | |||||||||
| Address1: | 2111 VAN DEMAN ST | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212246609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4438960710 | ||||||||
| FaxNumber: | 6123670841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2013 | ||||||||
| LastUpdateDate: | 10/24/2013 | ||||||||
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| AuthorizedOfficialLastName: | SOUZA | ||||||||
| AuthorizedOfficialFirstName: | DIANE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8607026176 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.