Provider Demographics
NPI:1487702650
Name:WOMEN PAVILLION
Entity type:Organization
Organization Name:WOMEN PAVILLION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:POSTAL
Authorized Official - Suffix:
Authorized Official - Credentials:NREMT
Authorized Official - Phone:419-255-7769
Mailing Address - Street 1:328 22ND ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43624-1002
Mailing Address - Country:US
Mailing Address - Phone:419-255-7769
Mailing Address - Fax:419-259-2644
Practice Address - Street 1:328 22ND ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43624-1002
Practice Address - Country:US
Practice Address - Phone:419-255-7769
Practice Address - Fax:419-259-2644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical