Provider Demographics
NPI:1942300074
Name:THE WOMEN'S CENTRE PC
Entity Type:Organization
Organization Name:THE WOMEN'S CENTRE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:HANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-249-6737
Mailing Address - Street 1:715 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-4209
Mailing Address - Country:US
Mailing Address - Phone:970-249-6737
Mailing Address - Fax:970-252-0112
Practice Address - Street 1:715 S 3RD ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4209
Practice Address - Country:US
Practice Address - Phone:970-249-6737
Practice Address - Fax:970-252-0112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28740207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO21402574Medicaid
CO21402574Medicaid