Healthcare Provider Details

I. General information

NPI: 1679369094
Provider Name (Legal Business Name): BEULAH WOMENS HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 CHESTNUT ST STE 2
PHILADELPHIA PA
19102-2700
US

IV. Provider business mailing address

1500 CHESTNUT ST STE 2
PHILADELPHIA PA
19102-2700
US

V. Phone/Fax

Practice location:
  • Phone: 484-897-6003
  • Fax: 445-999-5440
Mailing address:
  • Phone: 484-897-6003
  • Fax: 445-999-5440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: OBOT TIGAH
Title or Position: OWNER
Credential:
Phone: 484-897-6003