Provider Demographics
NPI:1316989866
Name:RICHMOND WOMEN'S HEALTH CARE, LLC
Entity type:Organization
Organization Name:RICHMOND WOMEN'S HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-624-2229
Mailing Address - Street 1:795 EASTERN BYP
Mailing Address - Street 2:BUILDING 2, SUITE 5
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2406
Mailing Address - Country:US
Mailing Address - Phone:859-624-2229
Mailing Address - Fax:859-625-9458
Practice Address - Street 1:795 EASTERN BYP
Practice Address - Street 2:BUILDING 2, SUITE 5
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2406
Practice Address - Country:US
Practice Address - Phone:859-624-2229
Practice Address - Fax:859-625-9458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY207V00000X
KY2048M363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65937757Medicaid
KY65937757Medicaid