Provider Demographics
NPI:1699725853
Name:WOMENS HEALTH BOUTIQUE WEINBERG CENTER
Entity type:Organization
Organization Name:WOMENS HEALTH BOUTIQUE WEINBERG CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-332-9859
Mailing Address - Street 1:227 SAINT PAUL PLACE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-2001
Mailing Address - Country:US
Mailing Address - Phone:410-332-9859
Mailing Address - Fax:410-843-2068
Practice Address - Street 1:227 SAINT PAUL PLACE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2001
Practice Address - Country:US
Practice Address - Phone:410-332-9859
Practice Address - Fax:410-843-2068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD345926OtherMAMSI/OPTIMUM CHOICE/ALLI
MD51347OtherAMERIGROUP
MDMH09WOOtherCAREFIRST
MD699568300Medicaid
MD81309OtherNORTHWOOD NPN
MDF799OtherFEDERAL BLUE CROSS
MDMH09WOOtherCAREFIRST