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General NPI Number Information
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NPI Number | 1225912306
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Entity Type | Organization
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Legal Business Name | BOSS LADY BY MIA
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Dates
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Enumeration Date | 08/02/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 2710 PLEASANT AVE APT 4
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City | NORFOLK
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State | VA
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Zip | 23518-1250
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Country | US
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Telephone | 757-589-5292
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Fax |
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Provider Business Mailing Address
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Address Line | 2710 PLEASANT AVE APT 4
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City | NORFOLK
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State | VA
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Zip | 23518-1250
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Country | US
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Telephone | 757-589-5292
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MIA ANNETTE ARMSTEAD
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Credential |
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Telephone | 757-589-5292
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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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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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