Provider Demographics
NPI:1093143117
Name:NEW MOMMY'S MATERNITY BREASTFEEDING & SUPPLIES
Entity Type:Organization
Organization Name:NEW MOMMY'S MATERNITY BREASTFEEDING & SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUISNESS OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:LORENA
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-525-9259
Mailing Address - Street 1:3291 DEL REY BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-5045
Mailing Address - Country:US
Mailing Address - Phone:575-525-9259
Mailing Address - Fax:
Practice Address - Street 1:3291 DEL REY BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88012-5045
Practice Address - Country:US
Practice Address - Phone:575-525-9259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies