Provider Demographics
NPI:1487203196
Name:UNIVERSITY HEALTH CENTER
Entity type:Organization
Organization Name:UNIVERSITY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:WING
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:423-236-2713
Mailing Address - Street 1:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:COLLEGEDALE
Mailing Address - State:TN
Mailing Address - Zip Code:37315
Mailing Address - Country:US
Mailing Address - Phone:423-236-2713
Mailing Address - Fax:423-236-1713
Practice Address - Street 1:4687 UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363
Practice Address - Country:US
Practice Address - Phone:423-236-2713
Practice Address - Fax:423-236-2713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health