Provider Demographics
NPI:1275525289
Name:BIRTH CARE & FAMILY HEALTH SERVICES
Entity Type:Organization
Organization Name:BIRTH CARE & FAMILY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MAREN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KETCHAM
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:717-786-5506
Mailing Address - Street 1:PO BOX 152
Mailing Address - Street 2:
Mailing Address - City:BART
Mailing Address - State:PA
Mailing Address - Zip Code:17503-0152
Mailing Address - Country:US
Mailing Address - Phone:717-786-5506
Mailing Address - Fax:717-786-5507
Practice Address - Street 1:1138 GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:CHRISTIANA
Practice Address - State:PA
Practice Address - Zip Code:17509-9720
Practice Address - Country:US
Practice Address - Phone:717-786-5506
Practice Address - Fax:717-786-5507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0002261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007781850004Medicaid