Provider Demographics
NPI:1326164138
Name:THE PA STATE UNIVERSITY-UNIVERSITY HEALTH SERVICES
Entity type:Organization
Organization Name:THE PA STATE UNIVERSITY-UNIVERSITY HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASST. DIRECTOR OF UHS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:NATAHSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUMGARTNER
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:814-865-3585
Mailing Address - Street 1:542 EISENHOWER RD
Mailing Address - Street 2:202C STUDENT HEALTH CENTER
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:16802-4601
Mailing Address - Country:US
Mailing Address - Phone:814-865-9321
Mailing Address - Fax:814-863-5371
Practice Address - Street 1:542 EISENHOWER RD
Practice Address - Street 2:202C STUDENT HEALTH CENTER
Practice Address - City:UNIVERSITY PARK
Practice Address - State:PA
Practice Address - Zip Code:16802-4601
Practice Address - Country:US
Practice Address - Phone:814-865-9321
Practice Address - Fax:814-863-5371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAHP418150L3336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2080921OtherPK
PA1002707420005Medicaid