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General NPI Number Information
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NPI Number | 1609307735
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Entity Type | Organization
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Legal Business Name | MAGNOLIA BIRTH CENTER - MIDWIFERY & WOMEN'S HEALTH
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 2122 ENTERPRISE RD
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City | GREENSBORO
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State | NC
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Zip | 27408-7004
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Country | US
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Telephone | 336-763-5123
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Fax |
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Provider Business Mailing Address
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Address Line | 2122 ENTERPRISE RD
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City | GREENSBORO
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State | NC
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Zip | 27408-7004
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Country | US
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Telephone | 336-763-5123
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Fax |
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Authorized Official
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Title or Position | OWNER, CEO
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Name | TANYA BAILEY
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Credential | CNM
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Telephone | 336-456-3896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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