Provider Demographics
NPI:1285789362
Name:WOMEN'S HEALTH FOR LIFE, INC.
Entity type:Organization
Organization Name:WOMEN'S HEALTH FOR LIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:R
Authorized Official - Last Name:FILLHART
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:419-227-2727
Mailing Address - Street 1:1005 BELLEFONTAINE AVE
Mailing Address - Street 2:SUITE 175
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2851
Mailing Address - Country:US
Mailing Address - Phone:419-227-2727
Mailing Address - Fax:419-227-2737
Practice Address - Street 1:1005 BELLEFONTAINE AVE
Practice Address - Street 2:SUITE 175
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2851
Practice Address - Country:US
Practice Address - Phone:419-227-2727
Practice Address - Fax:419-227-2737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006432K207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3012804Medicaid
OH9309031Medicare PIN