MEDICARE: YUMMY MUMMY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346590973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YUMMY MUMMY, LLC

Provider Business Mailing Address
First Line	:	1751 2ND AVENUE
Second Line	:	SUITE 203
City	:	NEW YORK
State	:	NY
Zip	:	10128-5363
Country	:	US
Telephone Number	:	855-879-8669
Fax Number	:	516-931-6348

Provider Business Practice Location Address
First Line	:	1751 2ND AVENUE
Second Line	:	SUITE 203
City	:	NEW YORK
State	:	NY
Zip	:	10128-5363
Country	:	US
Telephone Number	:	855-879-8669
Fax Number	:	516-931-6348

Authorized Official
Title or Position	:	FOUNDER/PRESIDENT
Name	:	MS. AMANDA LAUREN COLE
Credential	:	CEO
Telephone Number	:	212-879-8669

Provider Enumeration Date	:	09/11/2012
Last Update Date	:	06/04/2026

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