Healthcare Provider Details

I. General information

NPI: 1356981492
Provider Name (Legal Business Name): AFFILIATED REPRODUCTIVE HEALTH CLINICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2020
Last Update Date: 01/07/2020
Certification Date: 01/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10401 OLD GEORGETOWN RD STE 208
BETHESDA MD
20814-1911
US

IV. Provider business mailing address

1002 W MISSION AVE
BELLEVUE NE
68005-3947
US

V. Phone/Fax

Practice location:
  • Phone: 402-292-4164
  • Fax: 402-291-4643
Mailing address:
  • Phone: 402-292-4164
  • Fax: 402-291-4643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: CHELSEA SOUDER
Title or Position: VICE PRESIDENT
Credential: MPH
Phone: 402-292-4164