Provider Demographics
NPI:1215758859
Name:UNISERVSLLC
Entity type:Organization
Organization Name:UNISERVSLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:COOPER
Authorized Official - Middle Name:
Authorized Official - Last Name:KHOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-996-4440
Mailing Address - Street 1:705 KEYSTONE DR UNIT 23
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560
Mailing Address - Country:US
Mailing Address - Phone:978-996-4440
Mailing Address - Fax:
Practice Address - Street 1:705 KEYSTONE DR UNIT 23
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560
Practice Address - Country:US
Practice Address - Phone:978-996-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)