Organization
WOMENCARE, INC
Active
Organization
WOMENCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE DIANNE RAY (CREDENTIALING SPECIALIST)
(304) 757-6999
Entity
Organization
Contact information
Practice address
515 MAIN ST, MADISON, WV 25130-1417
(304) 369-0393
Mailing address
97 GREAT TEAYS BLVD STE 6, SCOTT DEPOT, WV 25560-9816
(304) 757-9999
(304) 201-5019
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001710197
MS BCBS
WV
01
—
001710198
MS BCBS
WV
05
—
1740450089
—
WV
05
—
3810011881
—
WV
01
—
C15043
RR MEDICARE GROUP
WV
Enumeration date
03/03/2008
Last updated
05/24/2022
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