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General NPI Number Information
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NPI Number | 1225101561
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Entity Type | Organization
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Legal Business Name | CHARLOTTE'S FASHIONS, LLC
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 03/17/2010
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Provider Practice Location Address
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Address Line | 1900 S TELSHOR BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88011-4898
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Country | US
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Telephone | 575-522-3903
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Fax | 575-522-3903
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Provider Business Mailing Address
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Address Line | 1900 S TELSHOR BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88011-4898
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Country | US
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Telephone | 575-522-3903
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Fax | 575-522-3903
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Authorized Official
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Title or Position | MEMBER/MANAGER
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Name | MRS. CHARLOTTE SUE DEERMAN
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Credential | CMF
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Telephone | 575-522-3903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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