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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891740536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONAL WOMEN'S HEALTH GROUP, LLC

Provider Business Mailing Address
First Line	:	PO BOX 536
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-0536
Country	:	US
Telephone Number	:	856-669-6050
Fax Number	:	856-651-0794

Provider Business Practice Location Address
First Line	:	150 CENTURY PKWY
Second Line	:	SUITE A
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-1129
Country	:	US
Telephone Number	:	856-778-1881
Fax Number	:	856-778-1572

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

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	08/22/2020

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