Healthcare Provider Details

I. General information

NPI: 1578823167
Provider Name (Legal Business Name): BLANCHARD VALLEY WOMEN'S CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2012
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W MARKET ST
TIFFIN OH
44883-2610
US

IV. Provider business mailing address

1917 S MAIN ST
FINDLAY OH
45840-1208
US

V. Phone/Fax

Practice location:
  • Phone: 419-455-1116
  • Fax:
Mailing address:
  • Phone: 419-420-0904
  • Fax: 419-420-1893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: KARON KUJAWA
Title or Position: OFFICE MANAGER
Credential: RN
Phone: 419-420-0904