Provider Demographics
NPI:1144236993
Name:CULL WOMEN'S HEALTHCARE
Entity Type:Organization
Organization Name:CULL WOMEN'S HEALTHCARE
Other - Org Name:THE LAUREL CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE/BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:D'ALANNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-888-2855
Mailing Address - Street 1:95 S LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-9301
Mailing Address - Country:US
Mailing Address - Phone:614-888-2855
Mailing Address - Fax:614-888-8576
Practice Address - Street 1:95 S LIBERTY ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-9301
Practice Address - Country:US
Practice Address - Phone:614-888-2855
Practice Address - Fax:614-888-8576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35064232174400000X
261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCU9318931Medicare ID - Type UnspecifiedGROUP POW/DEL
OHG0093Medicare UPIN
OHCU9318932Medicare ID - Type UnspecifiedGROUP POW/DEL