Healthcare Provider Details

I. General information

NPI: 1114184785
Provider Name (Legal Business Name): COMMUNITY WOMENS CARE OF BERKS COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 04/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15200 KUTZTOWN RD
KUTZTOWN PA
19530-9335
US

IV. Provider business mailing address

1017 DURYEA AVE
READING PA
19605-1159
US

V. Phone/Fax

Practice location:
  • Phone: 610-683-4646
  • Fax: 610-683-4635
Mailing address:
  • Phone: 610-926-6424
  • Fax: 610-370-2504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW008557L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberMW008557L
License Number StatePA

VIII. Authorized Official

Name: MRS. JOYCE DIECKMANN WARD
Title or Position: OWNER/PRESIDENT
Credential: MSM,CNM
Phone: 610-781-7040