NPIMap

Organization Active NPI

United Health Services Hospitals Inc

  • Community/Retail Pharmacy
  • Johnson City, NY
National Provider Identifier
1821392663
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
030662 Issued in NY
Legal business name
UNITED HEALTH SERVICES HOSPITALS INC
Doing business as
United Health Services Hospitals Inc
Practice address
345 Main St Ste B
Johnson City, NY 13790-2050
Phone
(607) 763-6775
Fax
(607) 763-6865
NPI assigned
Jan 10, 2011
Last updated
Mar 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William Waldron
Title
Director of Pharmacy
Phone
(607) 763-1835

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 030662 NY Primary

Addresses

Primary practice location

345 Main St Ste B
Johnson City, NY 13790-2050

Mailing address

345 Main St Ste B
Johnson City, NY 13790-2050
Phone (607) 763-6775

Other identifiers 2

IdentifierTypeStateIssuer
03437854MedicaidNY
2128335OtherPK

Other names 1

  • United Health Services Hospitals Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120221000554 NY DME Supplier - Pharmacy 5193610533 Practice locations: Johnson City, NY
O20210219002204 NY Part B Supplier - Pharmacy 5193610533 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vestal, NY; Johnson City, NY; Binghamton, NY; Endicott, NY

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Arun P Shah15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

345 Main St
Ste A
Johnson City, NY 13790
Phone (607) 352-5948

345 Main St
Ste B
Johnson City, NY 13790
Phone (607) 763-6775

52 Harrison St
Johnson City, NY 13790
Phone (607) 729-8845

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1821392663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 MAIN ST STE B",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902050",
            "telephone_number": "607-763-6775",
            "fax_number": "607-763-6865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 MAIN ST STE B",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902050",
            "telephone_number": "607-763-6775",
            "fax_number": "607-763-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED HEALTH SERVICES HOSPITALS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2024-03-26",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "WALDRON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "607-763-1835"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "030662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03437854",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2128335",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Health Services Hospitals Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnson City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.