Provider Demographics
NPI:1568232734
Name:SHELBY WOMEN HEALTH LLC
Entity Type:Organization
Organization Name:SHELBY WOMEN HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-767-7147
Mailing Address - Street 1:8957 EDMONSTON RD STE K
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-4046
Mailing Address - Country:US
Mailing Address - Phone:301-767-7147
Mailing Address - Fax:301-441-3672
Practice Address - Street 1:9470 ANNAPOLIS RD STE 414
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3000
Practice Address - Country:US
Practice Address - Phone:301-767-7147
Practice Address - Fax:301-441-3672
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHELBY WOMEN HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory