Provider Demographics
NPI:1972502201
Name:SALEM WOMEN'S CARE, INC
Entity Type:Organization
Organization Name:SALEM WOMEN'S CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS SECRETARY/PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:880-382-1989
Mailing Address - Street 1:2094 E STATE ST
Mailing Address - Street 2:STE B
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-4409
Mailing Address - Country:US
Mailing Address - Phone:330-332-1989
Mailing Address - Fax:330-332-2233
Practice Address - Street 1:2094 E STATE ST
Practice Address - Street 2:STE B
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-4409
Practice Address - Country:US
Practice Address - Phone:330-332-1989
Practice Address - Fax:330-332-2233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA215531OtherUPMC
OH2196618Medicaid
PA215531OtherUPMC
=========OtherHEALTH ASSURANCE
OH2196618Medicaid
=========OtherCIGNA HEALTHSOURCE
=========OtherTRICARE
=========OtherHEALTH NET FEDERAL