Provider Demographics
NPI:1487129623
Name:UNIVERSAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:UNIVERSAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR /REGISTERED NURSE.
Authorized Official - Prefix:
Authorized Official - First Name:MELLEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-843-1255
Mailing Address - Street 1:1359 KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-4624
Mailing Address - Country:US
Mailing Address - Phone:763-843-1255
Mailing Address - Fax:
Practice Address - Street 1:1359 KNOLL DR
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-4624
Practice Address - Country:US
Practice Address - Phone:763-843-1255
Practice Address - Fax:651-571-0018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty