Provider Demographics
NPI:1134673841
Name:COMMUNITY MIDWIFERY SERVICES. LLC
Entity Type:Organization
Organization Name:COMMUNITY MIDWIFERY SERVICES. LLC
Other - Org Name:COMMUNITY MIDWIFERY BIRTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CPM
Authorized Official - Phone:405-447-9433
Mailing Address - Street 1:2121 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6459
Mailing Address - Country:US
Mailing Address - Phone:405-447-9433
Mailing Address - Fax:405-703-9089
Practice Address - Street 1:2121 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6459
Practice Address - Country:US
Practice Address - Phone:405-447-9433
Practice Address - Fax:405-703-9089
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY MIDWIFERY SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-10
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing