Organization
MOTHERS' MILK BANK AT AUSTIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY UPDEGROVE CNM, MPH, MSN (EXECUTIVE DIRECTOR)
(512) 494-0800
Entity
Organization
Contact information
Practice address
5925 DILLARD CIRCLE, AUSTIN, TX 78752
(512) 494-0800
(512) 494-0880
Mailing address
5925 DILLARD CIRCLE, AUSTIN, TX 78752
(512) 494-0800
(512) 494-0880
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0057887-01
—
TX
Enumeration date
03/13/2007
Last updated
03/29/2021
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