MEDICARE: NEVER THE SAME BOUTIQUE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447364120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEVER THE SAME BOUTIQUE

Provider Business Mailing Address
First Line	:	1497 KENNEDY RD
Second Line	:	SUITE B
City	:	TIFTON
State	:	GA
Zip	:	31794-4159
Country	:	US
Telephone Number	:	229-382-3322
Fax Number	:	229-382-4044

Provider Business Practice Location Address
First Line	:	1497 KENNEDY RD
Second Line	:	SUITE B
City	:	TIFTON
State	:	GA
Zip	:	31794-4159
Country	:	US
Telephone Number	:	229-382-3322
Fax Number	:	229-382-4044

Authorized Official
Title or Position	:	OWNER
Name	:	MS. GAIL MAROIE FLEMING
Credential	:
Telephone Number	:	229-382-3322

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	02/05/2024

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Directions to “NEVER THE SAME BOUTIQUE ” Practice Location

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