Provider Demographics
NPI:1093248015
Name:THE KANE CLINIC'S, LLC
Entity Type:Organization
Organization Name:THE KANE CLINIC'S, LLC
Other - Org Name:INTERNATIONAL WOMENS HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:B
Authorized Official - Last Name:ARRIAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-250-4447
Mailing Address - Street 1:2000 CLEARVIEW AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:DORAVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30340-2100
Mailing Address - Country:US
Mailing Address - Phone:404-250-4447
Mailing Address - Fax:770-451-3343
Practice Address - Street 1:2000 CLEARVIEW AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:DORAVILLE
Practice Address - State:GA
Practice Address - Zip Code:30340-2100
Practice Address - Country:US
Practice Address - Phone:404-250-4447
Practice Address - Fax:770-451-3343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003145697AMedicaid