Provider Demographics
NPI:1932266236
Name:CMH WOMENS HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:CMH WOMENS HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:LIBBY
Authorized Official - Suffix:JR
Authorized Official - Credentials:CPA
Authorized Official - Phone:434-447-3151
Mailing Address - Street 1:420 BRACEY LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-1631
Mailing Address - Country:US
Mailing Address - Phone:434-774-3266
Mailing Address - Fax:
Practice Address - Street 1:420 BRACEY LN
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:VA
Practice Address - Zip Code:23970-1631
Practice Address - Country:US
Practice Address - Phone:434-774-3266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherGROUP TAX ID NUMBER