Provider Demographics
NPI:1164712246
Name:HEALTHCARE FOR WOMEN LLC
Entity Type:Organization
Organization Name:HEALTHCARE FOR WOMEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:VERED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-882-1433
Mailing Address - Street 1:2376 N 400 E
Mailing Address - Street 2:202
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-3413
Mailing Address - Country:US
Mailing Address - Phone:435-882-1433
Mailing Address - Fax:435-882-1431
Practice Address - Street 1:2376 N 400 E
Practice Address - Street 2:202
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-3413
Practice Address - Country:US
Practice Address - Phone:435-882-1433
Practice Address - Fax:435-882-1431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6934299-1205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty