Healthcare Provider Details

I. General information

NPI: 1346664737
Provider Name (Legal Business Name): OH BABY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 MINKUM RD
GAFFNEY SC
29340-6133
US

IV. Provider business mailing address

340 MINKUM RD
GAFFNEY SC
29340-6133
US

V. Phone/Fax

Practice location:
  • Phone: 864-490-3697
  • Fax:
Mailing address:
  • Phone: 864-490-3697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number205584
License Number StateSC

VIII. Authorized Official

Name: GENA B HENDERSON
Title or Position: OWNER
Credential: RN, CCE, IBCLC
Phone: 864-490-3697