Provider Demographics
NPI:1376228049
Name:PEARL GIRL CLINICS LLC
Entity Type:Organization
Organization Name:PEARL GIRL CLINICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERSHBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:316-687-3275
Mailing Address - Street 1:1821 E MADISON AVE STE 1100
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-2300
Mailing Address - Country:US
Mailing Address - Phone:316-669-8082
Mailing Address - Fax:316-669-9688
Practice Address - Street 1:1821 E MADISON AVE STE 1100
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-2300
Practice Address - Country:US
Practice Address - Phone:316-669-8082
Practice Address - Fax:316-669-9688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty