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General NPI Number Information
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NPI Number | 1922788041
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Entity Type | Organization
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Legal Business Name | PRETTY MOMENTS BOUTIQUE CARE LLC
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 7577 CENTRAL PARKE BLVD STE 224
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City | MASON
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State | OH
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Zip | 45040-6806
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Country | US
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Telephone | 513-223-1295
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Fax |
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Provider Business Mailing Address
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Address Line | 517 S COOPER AVE
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City | CINCINNATI
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State | OH
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Zip | 45215-4501
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Country | US
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Telephone | 513-223-1295
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | LASHAUNDA DELORES VAUGHN
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Credential |
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Telephone | 513-223-1295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224900000X
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Taxonomy Name | Mastectomy Fitter
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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 | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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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 | 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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