Provider Demographics
NPI:1831588565
Name:WOMEN'S CARE CLINIC, PLC
Entity type:Organization
Organization Name:WOMEN'S CARE CLINIC, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:CHALFANT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:515-276-5543
Mailing Address - Street 1:2540 106TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-3736
Mailing Address - Country:US
Mailing Address - Phone:515-276-5543
Mailing Address - Fax:515-276-2682
Practice Address - Street 1:2540 106TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-3736
Practice Address - Country:US
Practice Address - Phone:515-276-5543
Practice Address - Fax:515-276-2682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-19
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-03263174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA7419309Medicaid
IA0706400Medicaid