Provider Demographics
NPI:1144555061
Name:UNIVERSITY CARE
Entity type:Organization
Organization Name:UNIVERSITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUPITA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FRY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:704-496-0088
Mailing Address - Street 1:1716 FLAT RIVER DR APT 104
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-5345
Mailing Address - Country:US
Mailing Address - Phone:704-496-0088
Mailing Address - Fax:
Practice Address - Street 1:1716 FLAT RIVER DR APT 104
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-5345
Practice Address - Country:US
Practice Address - Phone:704-496-0088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health