Provider Demographics
NPI:1902975659
Name:THE BIRTH CENTER HOLISTIC WOMEN'S HEALTHCARE LLC
Entity Type:Organization
Organization Name:THE BIRTH CENTER HOLISTIC WOMEN'S HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERIFIED MIDWIFE, CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DORINDA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:DOVE
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:302-658-2229
Mailing Address - Street 1:1508 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-3110
Mailing Address - Country:US
Mailing Address - Phone:302-658-2229
Mailing Address - Fax:302-658-2382
Practice Address - Street 1:1508 W 7TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3110
Practice Address - Country:US
Practice Address - Phone:302-658-2229
Practice Address - Fax:302-658-2382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000915940Medicaid
DEG00439Medicare ID - Type Unspecified