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Contact Information

A BEAUTIFUL YOU MASTECTOMY BOUTIQUE
2006 BLAINE ST
CALDWELL, ID83605-4343
 Phone: 208-985-5404
 Fax: 208-402-5959
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for A BEAUTIFUL YOU MASTECTOMY BOUTIQUE

NPI # 1902202708
LBN Legal business name A BEAUTIFUL YOU MASTECTOMY BOUTIQUE
Authorized official LEANNE KOVICK - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/06/2014
Last updated 11/06/2014 - About 12 years ago
Identifiers
ID License # CFM02746
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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