Healthcare Provider Details

I. General information

NPI: 1407617327
Provider Name (Legal Business Name): NORTH CAROLINA BIRTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2024
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 MLK BLVD
CHAPEL HILL NC
27514-2656
US

IV. Provider business mailing address

930 MLK BLVD
CHAPEL HILL NC
27514-2656
US

V. Phone/Fax

Practice location:
  • Phone: 919-338-7117
  • Fax: 919-338-7118
Mailing address:
  • Phone: 708-617-9641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: SAM CROSTON
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 630-290-0090