Organization
VITALITY GENERATION & MIDWIFERY, LLC
Active
Other names
My Family Birth Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORETTA S. SHUPE CPM (CEO)
(801) 628-4573
Entity
Organization
Contact information
Practice address
5319 S 500 E, STE C, OGDEN, UT 84405
(801) 917-6104
(801) 436-5182
Mailing address
431 E 2700 N, OGDEN, UT 84414
(801) 628-4573
(801) 436-5182
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
163WA2000X
Administrator Registered Nurse
—
—
176B00000X
Midwife
—
—
261QB0400X
Birthing Clinic/Center
Primary
—
—
Other
Enumeration date
10/31/2018
Last updated
12/31/2018
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