Provider Demographics
NPI:1669530424
Name:ALLIANCE FOR WOMEN'S HEALTH, INC.
Entity type:Organization
Organization Name:ALLIANCE FOR WOMEN'S HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-228-1000
Mailing Address - Street 1:310 S CABLE RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-3110
Mailing Address - Country:US
Mailing Address - Phone:419-228-1000
Mailing Address - Fax:419-227-3085
Practice Address - Street 1:310 S CABLE RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-3110
Practice Address - Country:US
Practice Address - Phone:419-228-1000
Practice Address - Fax:419-227-3085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2464113Medicaid
OH2464131Medicaid
OH2464122Medicaid
OH0158118Medicaid
OH2464140Medicaid
OH2464113Medicaid
OH9264281Medicare PIN
OH2464122Medicaid
OH9264285Medicare PIN
OH9264282Medicare PIN