Provider Demographics
NPI:1740751783
Name:SCARLET'S UNMENTIONABLES
Entity Type:Organization
Organization Name:SCARLET'S UNMENTIONABLES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CERTIFIED FITTER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHLOTE
Authorized Official - Suffix:
Authorized Official - Credentials:CMF
Authorized Official - Phone:319-333-7226
Mailing Address - Street 1:2771 OAKDALE BLVD STE 8
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-9747
Mailing Address - Country:US
Mailing Address - Phone:319-333-7226
Mailing Address - Fax:319-626-3250
Practice Address - Street 1:2771 OAKDALE BLVD STE 8
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-9747
Practice Address - Country:US
Practice Address - Phone:319-333-7226
Practice Address - Fax:319-626-3250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier