Provider Demographics
NPI:1437116498
Name:WOMEN'S HEALTH OF ROCKY MOUNT, PA
Entity Type:Organization
Organization Name:WOMEN'S HEALTH OF ROCKY MOUNT, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:GLYNNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-451-7060
Mailing Address - Street 1:804 ENGLISH RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-6032
Mailing Address - Country:US
Mailing Address - Phone:252-451-7060
Mailing Address - Fax:252-451-0146
Practice Address - Street 1:804 ENGLISH RD
Practice Address - Street 2:SUITE 210
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-6032
Practice Address - Country:US
Practice Address - Phone:252-451-7060
Practice Address - Fax:252-451-0146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2220828CMedicare PIN