Healthcare Provider Details

I. General information

NPI: 1972873560
Provider Name (Legal Business Name): WOMENS WELLNESS SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 01/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 N 29TH ST SUITE 2
PHILADELPHIA PA
19121-3620
US

IV. Provider business mailing address

1551 N 29TH ST SUITE 2
PHILADELPHIA PA
19121-3620
US

V. Phone/Fax

Practice location:
  • Phone: 571-572-8836
  • Fax:
Mailing address:
  • Phone: 571-572-8836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335G00000X
TaxonomyMedical Foods Supplier
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number21232229
License Number StatePA
# 5
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: DONNA M ALEXANDER
Title or Position: OWNER
Credential:
Phone: 571-572-8836