Provider Demographics
NPI:1184609232
Name:WOMEN'S CARE OB/GYN, INC.
Entity type:Organization
Organization Name:WOMEN'S CARE OB/GYN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-745-3080
Mailing Address - Street 1:201 5TH ST NE
Mailing Address - Street 2:SUITE #6
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-3017
Mailing Address - Country:US
Mailing Address - Phone:330-745-3080
Mailing Address - Fax:330-745-6534
Practice Address - Street 1:201 5TH ST NE
Practice Address - Street 2:SUITE #6
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-3017
Practice Address - Country:US
Practice Address - Phone:330-745-3080
Practice Address - Fax:330-745-6534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-6380174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0704447Medicaid
OH0704438Medicaid
OH9263991Medicare ID - Type UnspecifiedWOMEN'S CARE GROUP#
OH0704438Medicaid
OHA83052Medicare UPIN