Provider Demographics
NPI:1093337305
Name:SEW LUXE CUSTOMS, LLC
Entity Type:Organization
Organization Name:SEW LUXE CUSTOMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DYNNISHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES-MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-485-7947
Mailing Address - Street 1:10380 PERKINS RD UNIT 84232
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70884-5343
Mailing Address - Country:US
Mailing Address - Phone:225-485-7947
Mailing Address - Fax:985-275-8430
Practice Address - Street 1:8674 QUARTERS LAKE ROAD
Practice Address - Street 2:BUILDING 11 SUIT 1
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809
Practice Address - Country:US
Practice Address - Phone:225-485-7947
Practice Address - Fax:985-275-8430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier