Provider Demographics
NPI:1972950996
Name:WOMEN'S MEDICAL & SURGICAL CLINIC, INC.
Entity Type:Organization
Organization Name:WOMEN'S MEDICAL & SURGICAL CLINIC, INC.
Other - Org Name:MAMOU OB.GYN. & FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEDHA
Authorized Official - Middle Name:UPENDRA
Authorized Official - Last Name:KULKARNI
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, JD
Authorized Official - Phone:337-459-0481
Mailing Address - Street 1:805 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:MAMOU
Mailing Address - State:LA
Mailing Address - Zip Code:70554-2223
Mailing Address - Country:US
Mailing Address - Phone:337-468-2250
Mailing Address - Fax:337-468-2702
Practice Address - Street 1:805 CHERRY ST
Practice Address - Street 2:
Practice Address - City:MAMOU
Practice Address - State:LA
Practice Address - Zip Code:70554-2223
Practice Address - Country:US
Practice Address - Phone:337-468-2250
Practice Address - Fax:337-468-2702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-19
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health