Provider Demographics
NPI:1235112970
Name:SHENANDOAH WOMENS HEALTHCARE
Entity Type:Organization
Organization Name:SHENANDOAH WOMENS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-438-1314
Mailing Address - Street 1:240 LUCY DR
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8036
Mailing Address - Country:US
Mailing Address - Phone:540-438-1314
Mailing Address - Fax:540-438-0797
Practice Address - Street 1:240 LUCY DR
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8036
Practice Address - Country:US
Practice Address - Phone:540-438-1314
Practice Address - Fax:540-438-0797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-28
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06068Medicaid