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General NPI Number Information
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NPI Number | 1942949003
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Entity Type | Organization
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Legal Business Name | TANDEM COMMUNITY BIRTH CENTER AND POSTPARTUM HOUSE, INC.
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Dates
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Enumeration Date | 05/27/2022
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Last Update Date | 05/27/2022
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Provider Practice Location Address
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Address Line | 2613 E 3RD ST
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City | BLOOMINGTON
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State | IN
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Zip | 47401-5345
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Country | US
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Telephone | 215-317-7613
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Fax |
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Provider Business Mailing Address
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Address Line | 2613 E 3RD ST
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City | BLOOMINGTON
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State | IN
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Zip | 47401-5345
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Country | US
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Telephone | 215-317-7613
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JULIE DUHON
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Credential |
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Telephone | 812-727-0134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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