Provider Demographics
NPI:1114384542
Name:MOBILE HEALTH GLOBAL FOR WOMEN
Entity Type:Organization
Organization Name:MOBILE HEALTH GLOBAL FOR WOMEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO & LAB DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAKIYA
Authorized Official - Middle Name:MARYAM
Authorized Official - Last Name:ORAEFO
Authorized Official - Suffix:
Authorized Official - Credentials:MSC, MSHS, PHDC
Authorized Official - Phone:913-206-8894
Mailing Address - Street 1:1503 MAIN ST # 277
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64030-2538
Mailing Address - Country:US
Mailing Address - Phone:913-206-8894
Mailing Address - Fax:913-660-0536
Practice Address - Street 1:1503 MAIN ST # 277
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:MO
Practice Address - Zip Code:64030-2538
Practice Address - Country:US
Practice Address - Phone:913-206-8894
Practice Address - Fax:913-660-0536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-14
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251K00000X, 251V00000X, 305S00000X
MO26D2106942291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251V00000XAgenciesVoluntary or Charitable
No291U00000XLaboratoriesClinical Medical Laboratory
No305S00000XManaged Care OrganizationsPoint of Service