Provider Demographics
NPI:1760805907
Name:BIRTH CENTER AT NORTHERN SUN
Entity Type:Organization
Organization Name:BIRTH CENTER AT NORTHERN SUN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:TALBOT
Authorized Official - Last Name:ACKERLY
Authorized Official - Suffix:
Authorized Official - Credentials:ND, CPM
Authorized Official - Phone:207-798-3993
Mailing Address - Street 1:53 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-1234
Mailing Address - Country:US
Mailing Address - Phone:207-798-3993
Mailing Address - Fax:207-798-3999
Practice Address - Street 1:53 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1234
Practice Address - Country:US
Practice Address - Phone:207-798-3993
Practice Address - Fax:207-798-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing