Provider Demographics
NPI:1801155197
Name:SPECIAL DELIVERY BIRTH CENTER
Entity type:Organization
Organization Name:SPECIAL DELIVERY BIRTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSE MIDWIFE/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:CPM, CNM
Authorized Official - Phone:918-224-1605
Mailing Address - Street 1:4926 E 73RD ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-7007
Mailing Address - Country:US
Mailing Address - Phone:918-477-9343
Mailing Address - Fax:918-895-9159
Practice Address - Street 1:4926 E 73RD ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7007
Practice Address - Country:US
Practice Address - Phone:918-477-9343
Practice Address - Fax:918-895-9159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing