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General NPI Number Information
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NPI Number | 1518171834
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Entity Type | Organization
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Legal Business Name | WOMENS HEALTH CENTER INC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 01/19/2011
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Provider Practice Location Address
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Address Line | 1600 N GRAND AVE STE 400
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City | PUEBLO
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State | CO
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Zip | 81003-2760
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Country | US
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Telephone | 719-543-4000
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Fax | 719-543-1041
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Provider Business Mailing Address
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Address Line | 1600 N GRAND AVE STE 400
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City | PUEBLO
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State | CO
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Zip | 81003-2760
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Country | US
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Telephone | 719-543-4000
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Fax | 719-543-1041
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Authorized Official
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Title or Position | OWNER
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Name | GREGORY K BERRYMAN
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Credential | MD
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Telephone | 719-543-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
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License Number | 28180
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License Number State | CO
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