Healthcare Provider Details
I. General information
NPI: 1376763136
Provider Name (Legal Business Name): WOMEN'S BIRTH AND WELLNESS CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/26/2007
Last Update Date: 03/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
930 MARTIN LUTHER KING JR BLVD STE. 202
CHAPEL HILL NC
27514-2656
US
IV. Provider business mailing address
930 MARTIN LUTHER KING JR BLVD STE. 202
CHAPEL HILL NC
27514-2656
US
V. Phone/Fax
- Phone: 919-933-3301
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QB0400X |
| Taxonomy | Birthing Clinic/Center |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 208391 |
| Identifier Type | OTHER |
| Identifier State | NC |
| Identifier Issuer | MEDCOST GROUP # |
| # 2 | |
| Identifier | 7000091 |
| Identifier Type | MEDICAID |
| Identifier State | NC |
| Identifier Issuer | |
| # 3 | |
| Identifier | 002419079001 |
| Identifier Type | OTHER |
| Identifier State | NC |
| Identifier Issuer | UNITED HEALTHCARE GROUP # |
| # 4 | |
| Identifier | 3409985 |
| Identifier Type | MEDICAID |
| Identifier State | NC |
| Identifier Issuer | |
| # 5 | |
| Identifier | 015PN |
| Identifier Type | OTHER |
| Identifier State | NC |
| Identifier Issuer | BLUE CROSS GROUP # |
VIII. Authorized Official
Name:
MAUREEN
DARCEY
Title or Position: DIRECTOR OF MIDWIFERY SERVICES
Credential: CNM
Phone: 919-933-3301