Healthcare Provider Details

I. General information

NPI: 1609502525
Provider Name (Legal Business Name): BIRMINGHAM BREASTFEEDING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 07/06/2025
Certification Date: 07/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 BEVERLY HILLS DR
VESTAVIA HILLS AL
35216-1704
US

IV. Provider business mailing address

2100 BEVERLY HILLS DR
VESTAVIA HILLS AL
35216-1704
US

V. Phone/Fax

Practice location:
  • Phone: 205-881-2252
  • Fax: 205-882-5835
Mailing address:
  • Phone: 205-881-2252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State

VIII. Authorized Official

Name: JORDAN CLARKE
Title or Position: PRESIDENT
Credential: RN, IBCLC
Phone: 205-881-2252