Provider Demographics
NPI:1922190479
Name:ENTERPRISE WOMEN'S CENTER, LLC.
Entity Type:Organization
Organization Name:ENTERPRISE WOMEN'S CENTER, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHALAH
Authorized Official - Middle Name:
Authorized Official - Last Name:COZART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-393-0737
Mailing Address - Street 1:101 EAST BRUNSON STREET
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330
Mailing Address - Country:US
Mailing Address - Phone:334-393-0737
Mailing Address - Fax:334-393-0914
Practice Address - Street 1:101 EAST BRUNSON STREET
Practice Address - Street 2:SUITE 310
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330
Practice Address - Country:US
Practice Address - Phone:334-393-0737
Practice Address - Fax:334-393-0914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALI333Medicare ID - Type Unspecified