Provider Demographics
NPI:1639252570
Name:BREASTFEEDING SUPPORT NETWORK, INC
Entity Type:Organization
Organization Name:BREASTFEEDING SUPPORT NETWORK, INC
Other - Org Name:THE NURTURING MOTHER'S BOUTIQUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, IBCLC, CFM
Authorized Official - Phone:920-231-1611
Mailing Address - Street 1:2050 W 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-8072
Mailing Address - Country:US
Mailing Address - Phone:920-231-1611
Mailing Address - Fax:920-231-1697
Practice Address - Street 1:2050 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-8072
Practice Address - Country:US
Practice Address - Phone:920-231-1611
Practice Address - Fax:920-231-1697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI2597OtherNETWORK HEALTH INSURANCE
WI41731700Medicaid
WI2597OtherNETWORK HEALTH INSURANCE
WI41731700Medicaid