Healthcare Provider Details
I. General information
NPI: 1770334914
Provider Name (Legal Business Name): BREAST PUMPS UNLIMITED LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2024
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
865 N 1430 W
OREM UT
84057-6402
US
IV. Provider business mailing address
865 N 1430 W
OREM UT
84057-6402
US
V. Phone/Fax
- Phone: 435-267-0141
- Fax: 801-796-2688
- Phone: 435-267-0141
- Fax: 801-796-2688
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 14211501-1714 |
| Identifier Type | OTHER |
| Identifier State | UT |
| Identifier Issuer | DURABLE MEDICAL EQUIPMENT PROVIDERS |
VIII. Authorized Official
Name:
MONG DJIU
MATTHEW
KHO
Title or Position: CEO
Credential:
Phone: 801-787-6546