Healthcare Provider Details

I. General information

NPI: 1699021642
Provider Name (Legal Business Name): CORPORATE LACTATION SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2012
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1712 GREEN MOUNTAIN TPKE
CHESTER VT
05143-8321
US

IV. Provider business mailing address

1712 GREEN MOUNTAIN TPKE
CHESTER VT
05143-8321
US

V. Phone/Fax

Practice location:
  • Phone: 802-875-5683
  • Fax: 802-875-6455
Mailing address:
  • Phone: 802-875-5683
  • Fax: 802-875-6455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. HEATHER COLLIE CHASE
Title or Position: PRESIDENT/LACTATION CONSULTANT
Credential: RN, IBCLC
Phone: 802-875-5683