Provider Type Icon

ROBERTA'S LOVELY LADIES BOUTIQUE NPI 1174983050


NPI Information

NPI: 1174983050
Provider Name: ROBERTA'S LOVELY LADIES BOUTIQUE
Classification: Mastectomy Fitter - 224900000X
Entity Type: Organization
Address:
603 W. DELMAR
ALTON, IL
ZIP 62002
Phone: (618) 467-0640
Get Directions

ROBERTA'S LOVELY LADIES BOUTIQUE is a mastectomy fitter in Alton, IL. The provider is an individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services. ROBERTA'S LOVELY LADIES BOUTIQUE NPI is 1174983050. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

603 W. DELMAR
ALTON, IL
ZIP 62002
Phone: (618) 467-0640

The provider's authorized official is Carol A Logan .
The authorized official title is Owner and has the following contact phone number (618) 467-0095.

The enumeration date for this NPI number is 3/4/2016 and was last updated on 3/4/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1224900000XMastectomy FitterYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.