Provider Demographics
NPI:1720782089
Name:WOMENINCHARG3 GROUP
Entity type:Organization
Organization Name:WOMENINCHARG3 GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL RECORDS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SATOA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-907-2029
Mailing Address - Street 1:4155 SATELLITE BLVD APT 311
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5081
Mailing Address - Country:US
Mailing Address - Phone:800-890-3571
Mailing Address - Fax:800-890-3571
Practice Address - Street 1:4155 SATELLITE BLVD APT 311
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5081
Practice Address - Country:US
Practice Address - Phone:800-890-3571
Practice Address - Fax:800-890-3571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-29
Last Update Date:2023-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
No302R00000XManaged Care OrganizationsHealth Maintenance OrganizationGroup - Single Specialty