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General NPI Number Information
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NPI Number | 1619162500
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Entity Type | Organization
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Legal Business Name | CHARLESTON BIRTH PLACE, INC
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Dates
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Enumeration Date | 09/13/2007
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Last Update Date | 03/24/2020
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Provider Practice Location Address
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Address Line | 9133 TIMBER ST SUITE 101
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406
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Country | US
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Telephone | 843-818-1123
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Fax | 843-818-1126
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Provider Business Mailing Address
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Address Line | 1300 HOSPITAL DR STE 270
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-3244
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Country | US
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Telephone | 843-818-1123
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Fax | 843-818-1126
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | LESLEY RATHBUN
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Credential | CNM
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Telephone | 843-818-1123
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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 | BC-007
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License Number State | SC
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