Healthcare Provider Details

I. General information

NPI: 1114603552
Provider Name (Legal Business Name): BREASTFRIENDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 06/24/2023
Certification Date: 06/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6016 GAINSBOROUGH RD
AMARILLO TX
79106-3415
US

IV. Provider business mailing address

6016 GAINSBOROUGH RD
AMARILLO TX
79106-3415
US

V. Phone/Fax

Practice location:
  • Phone: 806-626-9826
  • Fax:
Mailing address:
  • Phone: 806-626-9826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. AMANDA CASTILLO
Title or Position: LACTATION CONSULTANT
Credential: RNC, IBCLC
Phone: 806-626-9826