Provider Demographics
NPI:1477715472
Name:UNIQUE LINGERIE, INC.
Entity Type:Organization
Organization Name:UNIQUE LINGERIE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:B
Authorized Official - Last Name:TURNER DEGENESTE
Authorized Official - Suffix:
Authorized Official - Credentials:CFM
Authorized Official - Phone:352-877-8700
Mailing Address - Street 1:5445 NE 1ST LN
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-3418
Mailing Address - Country:US
Mailing Address - Phone:352-877-8700
Mailing Address - Fax:352-608-9718
Practice Address - Street 1:1901 SE 18TH AVE STE 200A
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-8228
Practice Address - Country:US
Practice Address - Phone:352-877-8700
Practice Address - Fax:352-608-9718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy FitterGroup - Multi-Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6235770001Medicare NSC