Provider Demographics
NPI:1295915056
Name:UNION COUNTY WOMEN'S CARE, PA
Entity type:Organization
Organization Name:UNION COUNTY WOMEN'S CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MILLICENT
Authorized Official - Middle Name:AUGUSTA
Authorized Official - Last Name:FRANCIS-LANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-289-8129
Mailing Address - Street 1:1424 E FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-5160
Mailing Address - Country:US
Mailing Address - Phone:704-289-8129
Mailing Address - Fax:704-289-5967
Practice Address - Street 1:1424 E FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5160
Practice Address - Country:US
Practice Address - Phone:704-289-8129
Practice Address - Fax:704-289-5967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8933643Medicaid
SCN31816OtherMEDICAID SOUTH CAROLINA
TN2308771Medicare PIN