Provider Demographics
NPI:1760437164
Name:REGIONAL WOMEN'S HEALTH GROUP, LLC
Entity Type:Organization
Organization Name:REGIONAL WOMEN'S HEALTH GROUP, LLC
Other - Org Name:OB GYN CARE OF SOUTHERN NJ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:CASO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-669-6050
Mailing Address - Street 1:227 LAUREL RD
Mailing Address - Street 2:STE 300
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-8303
Mailing Address - Country:US
Mailing Address - Phone:856-669-6050
Mailing Address - Fax:856-651-0794
Practice Address - Street 1:406 E GIBBSBORO RD
Practice Address - Street 2:
Practice Address - City:LINDENWOLD
Practice Address - State:NJ
Practice Address - Zip Code:08021-1907
Practice Address - Country:US
Practice Address - Phone:856-435-7007
Practice Address - Fax:856-435-7077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8274606Medicaid
NJ038621Medicare ID - Type Unspecified