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General NPI Number Information
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NPI Number | 1508594490
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Entity Type | Organization
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Legal Business Name | CHERRY BLOSSOM INTIMATES INC
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 12150 ANNAPOLIS RD STE 309
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City | GLENN DALE
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State | MD
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Zip | 20769-9183
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Country | US
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Telephone | 301-291-5013
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Fax | 240-245-7900
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Provider Business Mailing Address
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Address Line | PO BOX 7193
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City | UPPER MARLBORO
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State | MD
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Zip | 20792-7193
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Country | US
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Telephone | 301-291-5013
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | REGINA HAMPTON
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Credential | MD
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Telephone | 301-580-0059
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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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