Provider Demographics
NPI:1992750129
Name:REGIONAL WOMENS HEALTH GROUP LLC
Entity type:Organization
Organization Name:REGIONAL WOMENS HEALTH GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:CASO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-669-6050
Mailing Address - Street 1:PO BOX 536
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-0536
Mailing Address - Country:US
Mailing Address - Phone:856-669-6050
Mailing Address - Fax:856-651-0794
Practice Address - Street 1:1636 RT 38 & EAYRESTOWN RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048
Practice Address - Country:US
Practice Address - Phone:609-261-7023
Practice Address - Fax:609-914-8471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2008-03-04
Deactivation Date:2007-01-05
Deactivation Code:
Reactivation Date:2007-03-02
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8328706Medicaid
NJ038816Medicare ID - Type Unspecified