Pansy'S Post Mastectomy Boutique, Inc.

LBN: Pansy'S Post Mastectomy Boutique, Inc.
Pansy'S Post Mastectomy Boutique, Inc. is an health care organization with primary practice located at 100 Redmond Rd Nw , Rome GA 30165-1536. The organization recently has only one registered license in Suppliers / Durable Medical Equipment & Medical Supplies, which is considered as the primary health care specialty. Pansy'S Post Mastectomy Boutique, Inc. can be contacted via phone (706) 232-6600, or through Goewey, Kenneth David via phone (706) 232-6600.

Contact Information

Primary practice address
100 Redmond Rd Nw Rome GA 30165-1536
Fax: (706) 232-6677
Website:
Authorized official contact:
Name: Goewey, Kenneth David

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 000484 Georgia

Profile Details

NPI number 1194904540
LBN Legal business name Pansy'S Post Mastectomy Boutique, Inc.
DBA Doing business as
Authorized official Goewey, Kenneth David
Entity Organization
Organization subpart 1 No
Enumeration date Nov 1st, 2007
Last updated Sep 12th, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194904540 NPPES
Georgia MEDICAID 585652876B

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