Provider Demographics
NPI:1528019171
Name:BLANCHARD VALLEY WOMEN'S CARE, LLC
Entity Type:Organization
Organization Name:BLANCHARD VALLEY WOMEN'S CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARON
Authorized Official - Middle Name:K
Authorized Official - Last Name:KUJAWA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:419-420-0904
Mailing Address - Street 1:1917 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1208
Mailing Address - Country:US
Mailing Address - Phone:419-420-0904
Mailing Address - Fax:419-420-1893
Practice Address - Street 1:1917 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1208
Practice Address - Country:US
Practice Address - Phone:419-420-0904
Practice Address - Fax:419-420-1893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-006597207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBL9335631Medicare PIN