Healthcare Provider Details

I. General information

NPI: 1326465956
Provider Name (Legal Business Name): BREASTFEEDING SPECIALISTS INC #1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2014
Last Update Date: 03/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34143 PRESTON DR
STERLING HEIGHTS MI
48312-5654
US

IV. Provider business mailing address

34143 PRESTON DR
STERLING HEIGHTS MI
48312-5654
US

V. Phone/Fax

Practice location:
  • Phone: 586-939-8378
  • Fax: 586-838-5366
Mailing address:
  • Phone: 586-939-8378
  • Fax: 586-838-5366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5302025134
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MS. ANNE FRANCES NORTON-KRAWCIW
Title or Position: CEO/OWNER
Credential: RPH,IBCLC,RLC
Phone: 586-939-8378