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General NPI Number Information
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NPI Number | 1215387857
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Entity Type | Organization
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Legal Business Name | BABY'S FIRST WOMB INC
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Dates
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Enumeration Date | 06/14/2016
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Last Update Date | 06/14/2016
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Provider Practice Location Address
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Address Line | 1404 N MAIN ST STE 100
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City | MERIDIAN
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State | ID
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Zip | 83642-2799
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Country | US
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Telephone | 208-789-0512
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Fax |
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Provider Business Mailing Address
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Address Line | 1404 N MAIN ST STE 100
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City | MERIDIAN
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State | ID
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Zip | 83642-2799
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Country | US
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Telephone | 208-789-0512
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | EDWARD L BAHR
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Credential |
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Telephone | 208-789-0512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | 123782
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License Number State | ID
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