Basic Information
Provider Information
NPI: 1972939171
EntityType: 2
ReplacementNPI:  
OrganizationName: REGIONAL WOMEN'S HEALTH GROUP, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: RWHG PHYSICIAN OWNED LABORATORY
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: PO BOX 1109
Address2:  
City: OAKS
State: PA
PostalCode: 194561109
CountryCode: US
TelephoneNumber: 6104824778
FaxNumber: 6106663310
Practice Location
Address1: 450 CRESSON BLVD
Address2: SUITE 300
City: OAKS
State: PA
PostalCode: 19456
CountryCode: US
TelephoneNumber: 4848420717
FaxNumber: 4848420705
Other Information
ProviderEnumerationDate: 09/19/2013
LastUpdateDate: 09/27/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: IMBESI
AuthorizedOfficialFirstName: CATHY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: DIRECTOR OF CREDENTIALING
AuthorizedOfficialTelephone: 6104824778
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102X032372PAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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