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General NPI Number Information
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NPI Number | 1043363013
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Entity Type | Organization
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Legal Business Name | HEALTHCARE FOR WOMEN, INC.
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Dates
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Enumeration Date | 01/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 304 TEACO RD SUITE G
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City | KENNETT
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State | MO
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Zip | 63857-3266
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Country | US
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Telephone | 573-888-4370
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Fax |
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Provider Business Mailing Address
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Address Line | 304 TEACO RD SUITE G
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City | KENNETT
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State | MO
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Zip | 63857-3266
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Country | US
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Telephone | 573-888-4370
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Fax |
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MICHELE R PEREZ
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Credential |
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Telephone | 573-888-4370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 117744
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License Number State | MO
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