1770752123 NPI number — ASHLAND CENTER FOR WOMEN'S HEALTH

Table of content: MICHELLE LYNNE GRIPPO MPT (NPI 1326296286)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770752123 NPI number — ASHLAND CENTER FOR WOMEN'S HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASHLAND CENTER FOR WOMEN'S HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770752123
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1327
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHLAND
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41105-1327
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-325-6888
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
617 23RD ST
Provider Second Line Business Practice Location Address:
STE 415
Provider Business Practice Location Address City Name:
ASHLAND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41101-2880
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-325-6888
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/29/2008

Additional Information

Authorized Official

Authorized Official Last Name:
FORD
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
606-325-6888

Provider Taxonomy Codes

  • Taxonomy code: 332900000X , with the licence number:  1830339 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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