Provider Demographics
NPI:1710009584
Name:PATHWAY WOMENS HEALTH PLC
Entity Type:Organization
Organization Name:PATHWAY WOMENS HEALTH PLC
Other - Org Name:FORMSMA KARI R SOLE MBR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARI
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:FORMSMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-969-8881
Mailing Address - Street 1:244 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3428
Mailing Address - Country:US
Mailing Address - Phone:269-969-8881
Mailing Address - Fax:269-969-8877
Practice Address - Street 1:244 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3428
Practice Address - Country:US
Practice Address - Phone:269-969-8881
Practice Address - Fax:269-969-8877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4764659Medicaid
MI0P17730Medicare PIN
MIG25945Medicare UPIN