Provider Demographics
NPI:1730670456
Name:CUMBERLAND VALLEY LACTATION LLC
Entity Type:Organization
Organization Name:CUMBERLAND VALLEY LACTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/LACTATION CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:PALERMINO
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:301-800-8114
Mailing Address - Street 1:12916 WOODBURN DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-2866
Mailing Address - Country:US
Mailing Address - Phone:301-800-8114
Mailing Address - Fax:
Practice Address - Street 1:864 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5015
Practice Address - Country:US
Practice Address - Phone:301-800-8114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR122553163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty