Healthcare Provider Details

I. General information

NPI: 1912994898
Provider Name (Legal Business Name): AUGUSTA HEALTH CARE FOR WOMEN, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 BEAM LN
FISHERSVILLE VA
22939-2348
US

IV. Provider business mailing address

39 BEAM LN
FISHERSVILLE VA
22939-2348
US

V. Phone/Fax

Practice location:
  • Phone: 540-213-7750
  • Fax: 540-213-7755
Mailing address:
  • Phone: 540-213-7750
  • Fax: 540-213-7755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: RENIE T GALFORD
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 540-213-7765