Provider Demographics
NPI:1215387857
Name:BABY'S FIRST WOMB INC
Entity Type:Organization
Organization Name:BABY'S FIRST WOMB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-789-0512
Mailing Address - Street 1:1404 N MAIN ST
Mailing Address - Street 2:STE 100
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-2799
Mailing Address - Country:US
Mailing Address - Phone:208-789-0512
Mailing Address - Fax:
Practice Address - Street 1:1404 N MAIN ST
Practice Address - Street 2:STE 100
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-2799
Practice Address - Country:US
Practice Address - Phone:208-789-0512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID1237822471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty