Healthcare Provider Details

I. General information

NPI: 1326681305
Provider Name (Legal Business Name): MARTHA & COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2019
Last Update Date: 10/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 MAIN STREET
YARMOUTH ME
04096-6745
US

IV. Provider business mailing address

121 MAIN STREET
YARMOUTH ME
04096-6745
US

V. Phone/Fax

Practice location:
  • Phone: 207-847-0675
  • Fax: 207-847-0687
Mailing address:
  • Phone: 207-847-0675
  • Fax: 207-847-0687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224900000X
TaxonomyMastectomy Fitter
License Number
License Number State

VIII. Authorized Official

Name: KATRINA A OJAKAAR
Title or Position: CERTIFIED MASTECTOMY FITTER/OWNER
Credential: CMF
Phone: 207-847-0675