Provider Demographics
NPI:1497247787
Name:PHILLY MIDWIFE COLLECTIVE
Entity Type:Organization
Organization Name:PHILLY MIDWIFE COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:M
Authorized Official - Last Name:CUTTS
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:267-398-5054
Mailing Address - Street 1:5500 WISSAHICKON AVE # M103A
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-5653
Mailing Address - Country:US
Mailing Address - Phone:484-243-0925
Mailing Address - Fax:
Practice Address - Street 1:270 W WALNUT LN FL 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-3204
Practice Address - Country:US
Practice Address - Phone:484-243-0925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing