Provider Demographics
NPI:1336318765
Name:WOMEN HEALTH SERVICES
Entity Type:Organization
Organization Name:WOMEN HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONACHAI
Authorized Official - Middle Name:
Authorized Official - Last Name:BANCHONGMANIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-375-4900
Mailing Address - Street 1:DEPT 8241
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60122-0001
Mailing Address - Country:US
Mailing Address - Phone:866-286-9915
Mailing Address - Fax:502-471-2051
Practice Address - Street 1:5341 MITSCHER AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-2633
Practice Address - Country:US
Practice Address - Phone:502-375-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17611207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty