Provider Demographics
NPI:1386980688
Name:BLOOMINGTON AREA BIRTH SERVICES
Entity type:Organization
Organization Name:BLOOMINGTON AREA BIRTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GEORG'ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CATTELONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-337-8121
Mailing Address - Street 1:2458 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-7730
Mailing Address - Country:US
Mailing Address - Phone:812-337-8121
Mailing Address - Fax:
Practice Address - Street 1:2458 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-7730
Practice Address - Country:US
Practice Address - Phone:812-337-8121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable