Provider Demographics
NPI:1891409918
Name:IVY MIDWIFERY SERVICES INC.
Entity Type:Organization
Organization Name:IVY MIDWIFERY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CELEST
Authorized Official - Middle Name:IVY
Authorized Official - Last Name:WINFREY
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM, IBCLC
Authorized Official - Phone:909-844-3019
Mailing Address - Street 1:2141 LA SIERRA WAY
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-1509
Mailing Address - Country:US
Mailing Address - Phone:909-844-3019
Mailing Address - Fax:323-680-4967
Practice Address - Street 1:2141 LA SIERRA WAY
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-1509
Practice Address - Country:US
Practice Address - Phone:909-844-3019
Practice Address - Fax:323-680-4967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center