MEDICARE: REGIONAL WOMEN'S HEALTH GROUP, LLC

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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1699068932
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONAL WOMEN'S HEALTH GROUP, LLC

Provider Business Mailing Address
First Line	:	227 LAUREL RD
Second Line	:	STE 300
City	:	VOORHEES
State	:	NJ
Zip	:	08043-8303
Country	:	US
Telephone Number	:	856-669-6025
Fax Number	:	856-651-0794

Provider Business Practice Location Address
First Line	:	1313 WOLF ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-2911
Country	:	US
Telephone Number	:	215-465-3000
Fax Number	:	215-465-1085

Authorized Official
Title or Position	:	CEO
Name	:	FRANK J CASO
Credential	:
Telephone Number	:	856-669-6050

Provider Enumeration Date	:	05/19/2011
Last Update Date	:	03/05/2012

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