Provider Demographics
NPI:1336181114
Name:WOMEN'S SPECIALTY CARE
Entity Type:Organization
Organization Name:WOMEN'S SPECIALTY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-256-1675
Mailing Address - Street 1:1501 N BICKETT BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-2178
Mailing Address - Country:US
Mailing Address - Phone:919-496-1054
Mailing Address - Fax:919-496-2509
Practice Address - Street 1:1501 N BICKETT BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2178
Practice Address - Country:US
Practice Address - Phone:919-496-1054
Practice Address - Fax:919-496-2509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty