Provider Demographics
NPI:1629024690
Name:PREMIER WOMEN'S HEALTH, LTD
Entity Type:Organization
Organization Name:PREMIER WOMEN'S HEALTH, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:LABUDA
Authorized Official - Suffix:
Authorized Official - Credentials:D0
Authorized Official - Phone:412-741-6530
Mailing Address - Street 1:301 OHIO RIVER BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1300
Mailing Address - Country:US
Mailing Address - Phone:412-741-6530
Mailing Address - Fax:412-741-6570
Practice Address - Street 1:301 OHIO RIVER BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1300
Practice Address - Country:US
Practice Address - Phone:412-741-6530
Practice Address - Fax:412-741-6570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006958L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011237050001Medicaid
PAB96193Medicare UPIN
PA014779H78Medicare ID - Type Unspecified