Provider Demographics
NPI:1467157172
Name:FOUNDATIONS LINGERIE & SWIM L.L.C.
Entity Type:Organization
Organization Name:FOUNDATIONS LINGERIE & SWIM L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOGOS
Authorized Official - Suffix:
Authorized Official - Credentials:CMF
Authorized Official - Phone:251-408-9416
Mailing Address - Street 1:2596 BRIGHTON CIR
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-2748
Mailing Address - Country:US
Mailing Address - Phone:228-424-1913
Mailing Address - Fax:228-241-1078
Practice Address - Street 1:30500 HIGHWAY 181
Practice Address - Street 2:217
Practice Address - City:SPANISH FORT
Practice Address - State:AL
Practice Address - Zip Code:36527
Practice Address - Country:US
Practice Address - Phone:251-408-9416
Practice Address - Fax:228-241-1078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies