Provider Demographics
NPI:1477694776
Name:SOUTH SUBURBAN WOMEN'S CENTER
Entity Type:Organization
Organization Name:SOUTH SUBURBAN WOMEN'S CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FARINACCI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:216-662-1900
Mailing Address - Street 1:13201 GRANGER RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-1978
Mailing Address - Country:US
Mailing Address - Phone:216-662-1900
Mailing Address - Fax:216-581-8201
Practice Address - Street 1:13201 GRANGER RD
Practice Address - Street 2:SUITE 3
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-1978
Practice Address - Country:US
Practice Address - Phone:216-662-1900
Practice Address - Fax:216-581-8201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty