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FQHCLA262A UNIVERSAL MEDICAL SERVICES, INC. (Active)
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Main Details
Name
UNIVERSAL MEDICAL SERVICES, INC.
Subdivision Name
Axis Lake
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-020830
340B ID
FQHCLA262A
Grant Number
LALCS00028
Additional Details
Current Program Status
Active
Registration Date
2/12/2020
Participating Start Date
4/1/2020
Participating Approval Date
3/10/2020
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Universal Medical Services d/b/a Axis Medical Center
Theodore James, CEO
(612) 823-2947 Ext: 826
Primary Contact
Universal Medical Services d/b/a Axis Medical Center
Haymanot Magruder, Manager
(612) 823-2947 Ext: 0829
Addresses
Street Address
1 W Lake St
Minneapolis, MN 55408-3154
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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