Provider Demographics
NPI:1467997916
Name:THE EDMOND BIRTHING CENTER, LLC
Entity Type:Organization
Organization Name:THE EDMOND BIRTHING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-419-8219
Mailing Address - Street 1:14901 N KELLY AVE
Mailing Address - Street 2:SUITE #102
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3883
Mailing Address - Country:US
Mailing Address - Phone:512-419-8219
Mailing Address - Fax:
Practice Address - Street 1:14901 N KELLY AVE
Practice Address - Street 2:SUITE #102
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3883
Practice Address - Country:US
Practice Address - Phone:512-419-8219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing