MEDICARE: OCEANSIDE MIDWIVES

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	176B00000X	Midwife

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861193807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEANSIDE MIDWIVES

Provider Business Mailing Address
First Line	:	802 41ST AVE S STE 109
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-5155
Country	:	US
Telephone Number	:	843-273-6304
Fax Number	:	843-419-8818

Provider Business Practice Location Address
First Line	:	802 41ST AVE S # 109
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-5155
Country	:	US
Telephone Number	:	843-273-6304
Fax Number	:	843-419-8818

Authorized Official
Title or Position	:	MIDWIFE/OWNER
Name	:	AUDREY ANNE TREPICCIONE
Credential	:	CPM, LM
Telephone Number	:	843-273-6304

Provider Enumeration Date	:	03/16/2023
Last Update Date	:	03/16/2023

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Directions to “OCEANSIDE MIDWIVES ” Practice Location

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