Provider Demographics
NPI:1265175285
Name:SOUTHWEST BREASTFEEDING SUPPLY LLC
Entity type:Organization
Organization Name:SOUTHWEST BREASTFEEDING SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-300-4559
Mailing Address - Street 1:29455 N CAVE CREEK RD STE 118-506
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-3245
Mailing Address - Country:US
Mailing Address - Phone:480-300-4559
Mailing Address - Fax:480-447-8890
Practice Address - Street 1:7730 E GREENWAY RD STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1787
Practice Address - Country:US
Practice Address - Phone:480-300-4559
Practice Address - Fax:480-447-8890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment