Provider Demographics
NPI:1538314539
Name:MLS LUXURY LINGERIE, LLC
Entity Type:Organization
Organization Name:MLS LUXURY LINGERIE, LLC
Other - Org Name:MYSHELLIE'S LINGERIE
Other - Org Type:Other Name
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SMILEY
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:870-530-3792
Mailing Address - Street 1:4815 MAGAZINE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-1652
Mailing Address - Country:US
Mailing Address - Phone:504-899-1875
Mailing Address - Fax:504-899-1875
Practice Address - Street 1:4815 MAGAZINE ST APT 2
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-1652
Practice Address - Country:US
Practice Address - Phone:504-899-1875
Practice Address - Fax:504-899-1875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA150873332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies