1679848014 NPI number — CURRENT OB/GYN WOMEN'S HEALTH CENTER, PLLC

Table of content: REBECCA REIS BEITENMAN PHARMD (NPI 1245826817)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679848014 NPI number — CURRENT OB/GYN WOMEN'S HEALTH CENTER, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CURRENT OB/GYN WOMEN'S HEALTH CENTER, PLLC
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:
1679848014
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
61 BONNIE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SYLVA
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28779-8511
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-631-1852
Provider Business Mailing Address Fax Number:
828-586-8209

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
61 BONNIE LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SYLVA
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28779-8511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-631-1852
Provider Business Practice Location Address Fax Number:
828-586-8209
Provider Enumeration Date:
03/19/2012

Additional Information

Authorized Official

Authorized Official Last Name:
CUSTER
Authorized Official First Name:
KELLY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
828-631-1852

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  2012-00202 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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