Pink Ribbon Mastectomy Boutique

LBN: Prosthetic Orthotic Center Lte
Pink Ribbon Mastectomy Boutique is an health care organization with primary practice located at 1108 S 17Th Ave , Wausau WI 54401-5709. The organization recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as the primary health care specialty. Prosthetic Orthotic Center Lte can be contacted via phone (715) 845-2800, or through Lotz, Elizabeth Ruth via phone (715) 845-2800.

Contact Information

Primary practice address
1108 S 17Th Ave Wausau WI 54401-5709
Phone: (715) 845-2800
Fax: (715) 845-2855
Website:
Map and Directions
Authorized official contact:
Name: Lotz, Elizabeth Ruth CFM, RFM
Phone: (715) 845-2800

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X

Profile Details

NPI number 1801907217
LBN Legal business name Prosthetic Orthotic Center Lte
DBA Doing business as Pink Ribbon Mastectomy Boutique
Authorized official Lotz, Elizabeth Ruth CFM, RFM
Entity Organization
Organization subpart 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 10th, 2013 - about 12 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 1801907217 NPPES
Wisconsin MEDICAID 41782800

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