Provider Demographics
NPI:1508292574
Name:MIDWIFERY SERVICES, LLC
Entity Type:Organization
Organization Name:MIDWIFERY SERVICES, LLC
Other - Org Name:ASHLAND BIRTH CENTER, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAVITA
Authorized Official - Middle Name:LOMIRA
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:715-413-0197
Mailing Address - Street 1:619 9TH AVE W
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54806-2808
Mailing Address - Country:US
Mailing Address - Phone:715-292-6367
Mailing Address - Fax:715-292-6367
Practice Address - Street 1:619 9TH AVE W
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806-2808
Practice Address - Country:US
Practice Address - Phone:715-292-6367
Practice Address - Fax:715-292-6367
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDWIFERY SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-22
Last Update Date:2013-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11-049302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization