Healthcare Provider Details

I. General information

NPI: 1326450206
Provider Name (Legal Business Name): RIVER VALLEY BIRTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 05/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 PARK ROW
SAINT PETER MN
56082-2059
US

IV. Provider business mailing address

526 PARK ROW
SAINT PETER MN
56082-2059
US

V. Phone/Fax

Practice location:
  • Phone: 507-934-1565
  • Fax:
Mailing address:
  • Phone: 507-934-1565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1023
License Number StateMN

VIII. Authorized Official

Name: MS. ERIKA URBAN
Title or Position: DIRECTOR
Credential: CPM, LM
Phone: 507-934-1565