Provider Demographics
NPI:1447398458
Name:INTIMATE SILHOUETTES BY FRAN
Entity Type:Organization
Organization Name:INTIMATE SILHOUETTES BY FRAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-298-6045
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:WALLACE
Mailing Address - State:NC
Mailing Address - Zip Code:28466-0099
Mailing Address - Country:US
Mailing Address - Phone:910-298-6045
Mailing Address - Fax:910-298-6259
Practice Address - Street 1:3501 HWY 24 E
Practice Address - Street 2:
Practice Address - City:BEULAVILLE
Practice Address - State:NC
Practice Address - Zip Code:28518
Practice Address - Country:US
Practice Address - Phone:910-298-6045
Practice Address - Fax:910-298-6259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7703838Medicaid
NC7703838Medicaid