Provider Demographics
NPI:1609502525
Name:BIRMINGHAM BREASTFEEDING LLC
Entity Type:Organization
Organization Name:BIRMINGHAM BREASTFEEDING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC
Authorized Official - Phone:205-881-2252
Mailing Address - Street 1:2100 BEVERLY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1704
Mailing Address - Country:US
Mailing Address - Phone:205-881-2252
Mailing Address - Fax:
Practice Address - Street 1:2100 BEVERLY HILLS DR
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1704
Practice Address - Country:US
Practice Address - Phone:205-881-2252
Practice Address - Fax:205-882-5835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty