MEDICARE: COMMUNITY BIRTH GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital

General Provider Information

NPI Number	:	1689153561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY BIRTH GROUP

Provider Business Mailing Address
First Line	:	216 TOWER RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78223-6018
Country	:	US
Telephone Number	:	800-341-8598
Fax Number	:	210-547-9603

Provider Business Practice Location Address
First Line	:	1172 E 4TH AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84103-4124
Country	:	US
Telephone Number	:	800-341-8598
Fax Number	:

Authorized Official
Title or Position	:	OFFICE STAFF
Name	:	ERIKA LEWIS
Credential	:
Telephone Number	:	800-341-8598

Provider Enumeration Date	:	08/10/2018
Last Update Date	:	06/09/2024

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Directions to “COMMUNITY BIRTH GROUP ” Practice Location

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