Provider Demographics
NPI:1649399486
Name:WOMENS HEALTH PROVIDERS LLC
Entity Type:Organization
Organization Name:WOMENS HEALTH PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:CNM MSN
Authorized Official - Phone:856-935-1900
Mailing Address - Street 1:330 SALEM WOODSTOWN ROAD
Mailing Address - Street 2:SUITE#6
Mailing Address - City:SALEM
Mailing Address - State:NJ
Mailing Address - Zip Code:08079
Mailing Address - Country:US
Mailing Address - Phone:856-935-1900
Mailing Address - Fax:856-935-1924
Practice Address - Street 1:330 SALEM WOODSTOWN ROAD
Practice Address - Street 2:SUITE#6
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079
Practice Address - Country:US
Practice Address - Phone:856-935-1900
Practice Address - Fax:856-935-1924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00026801261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service