Provider Demographics
NPI:1013403468
Name:THE BREAST WAY, LLC
Entity Type:Organization
Organization Name:THE BREAST WAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYA
Authorized Official - Middle Name:DAWNEY
Authorized Official - Last Name:CYPHERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-777-0335
Mailing Address - Street 1:20270 ARDWELL DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-1804
Mailing Address - Country:US
Mailing Address - Phone:216-777-0335
Mailing Address - Fax:
Practice Address - Street 1:20270 ARDWELL DR
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-1804
Practice Address - Country:US
Practice Address - Phone:216-777-0335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies