Provider Demographics
NPI:1639268915
Name:GENERATIONS WOMEN'S HEALTHCARE INC
Entity Type:Organization
Organization Name:GENERATIONS WOMEN'S HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-825-2355
Mailing Address - Street 1:1309 NORTON AVE
Mailing Address - Street 2:100
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203
Mailing Address - Country:US
Mailing Address - Phone:330-825-2355
Mailing Address - Fax:330-706-0213
Practice Address - Street 1:1309 NORTON AVE
Practice Address - Street 2:100
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203
Practice Address - Country:US
Practice Address - Phone:330-825-2355
Practice Address - Fax:330-706-0213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2422711Medicaid