Healthcare Provider Details

I. General information

NPI: 1144236993
Provider Name (Legal Business Name): CULL WOMEN'S HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 01/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 S LIBERTY ST
POWELL OH
43065-9301
US

IV. Provider business mailing address

95 S LIBERTY ST
POWELL OH
43065-9301
US

V. Phone/Fax

Practice location:
  • Phone: 614-888-2855
  • Fax: 614-888-8576
Mailing address:
  • Phone: 614-888-2855
  • Fax: 614-888-8576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number35064232
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. DANA M D'ALANNO
Title or Position: OFFICE/BILLING
Credential:
Phone: 614-888-2855