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Contact Information

FABULOUS WEAVE , LLC
10595 SOURWOOD AVE
WALDORF, MD20603-5730
 Phone: 301-645-8765
 Fax: 301-645-9611
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Customized Equipment

332BC3200X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for FABULOUS WEAVE , LLC

NPI Number 1083960801
LBN Legal business name FABULOUS WEAVE , LLC
Authorized official ANDREA DOCTOR - (RNCONSULT FOR CRANIAL PROSTHESIS)
Entity Organization
Organization subpart 1 No
Enumeration date 07/30/2012
Last updated 07/30/2012 - About 14 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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