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General NPI Number Information
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NPI Number | 1821033267
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Entity Type | Organization
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Legal Business Name | MARGRET'S MASTECTOMY SHOPPE, LTD.
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 95 ARCH ST SUITE 205
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City | AKRON
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State | OH
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Zip | 44304-1437
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Country | US
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Telephone | 330-761-2700
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Fax | 330-761-2701
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Provider Business Mailing Address
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Address Line | PO BOX 805
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City | CANFIELD
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State | OH
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Zip | 44406-0805
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Country | US
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Telephone | 330-518-3703
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Fax |
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Authorized Official
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Title or Position | VP OPERATIONS
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Name | MRS. ELIZABETH ANNE CIANCIOLA
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Credential |
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Telephone | 330-518-3703
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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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