1962568428 NPI number — THE BIRTH CENTER

Table of content: (NPI 1962568428)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962568428 NPI number — THE BIRTH CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE BIRTH CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LIFECYCLE WOMANCARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962568428
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
918 COUNTY LINE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRYN MAWR
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19010-2502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-525-6088
Provider Business Mailing Address Fax Number:
610-525-6631

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
918 COUNTY LINE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRYN MAWR
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19010-2502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-525-6088
Provider Business Practice Location Address Fax Number:
610-525-6631
Provider Enumeration Date:
12/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BRECHBIEL
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
L
Authorized Official Title or Position:
DIRECTOR OF FINANCE
Authorized Official Telephone Number:
484-381-3009

Provider Taxonomy Codes

  • Taxonomy code: 163WL0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 176B00000X , with the licence number: 80053300 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LX0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00110472170002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01047217-02 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4472880 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 8186 . This is a "AMERIHEALTH ADMIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: TH1305983 . This is a "PERSONAL CHOICE PROF" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: TH1305983 . This is a "BLUE SHIELD PROFESSIONAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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