MEDICARE: WOMEN'S SPECIALTY CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician		NC

General Provider Information

NPI Number	:	1336181114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOMEN'S SPECIALTY CARE

Provider Business Mailing Address
First Line	:	1501 N BICKETT BLVD
Second Line	:	SUITE D
City	:	LOUISBURG
State	:	NC
Zip	:	27549-2178
Country	:	US
Telephone Number	:	919-496-1054
Fax Number	:	919-496-2509

Provider Business Practice Location Address
First Line	:	1501 N BICKETT BLVD
Second Line	:	SUITE D
City	:	LOUISBURG
State	:	NC
Zip	:	27549-2178
Country	:	US
Telephone Number	:	919-496-1054
Fax Number	:	919-496-2509

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	PATTY HENRICH
Credential	:
Telephone Number	:	919-256-1675

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	08/22/2020

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