Provider Demographics
NPI:1306182233
Name:SHELBY WOMEN HEALTH LLC
Entity Type:Organization
Organization Name:SHELBY WOMEN HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:ZAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-982-9333
Mailing Address - Street 1:8957 EDMONSTON RD
Mailing Address - Street 2:K
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-1005
Mailing Address - Country:US
Mailing Address - Phone:301-982-9333
Mailing Address - Fax:301-441-3672
Practice Address - Street 1:8957 EDMONSTON RD
Practice Address - Street 2:K
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1005
Practice Address - Country:US
Practice Address - Phone:301-982-9333
Practice Address - Fax:301-441-3672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-20
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
No246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical LaboratoryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD222912900Medicaid