Provider Demographics
NPI:1336610823
Name:WHOLESOME LACTATION CARE, LLC
Entity Type:Organization
Organization Name:WHOLESOME LACTATION CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LACTATION CONSULTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAGO
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, IBCLC
Authorized Official - Phone:845-706-0941
Mailing Address - Street 1:5116 S LOCKWOOD RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-7428
Mailing Address - Country:US
Mailing Address - Phone:845-706-0941
Mailing Address - Fax:
Practice Address - Street 1:5116 S LOCKWOOD RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-7428
Practice Address - Country:US
Practice Address - Phone:845-706-0941
Practice Address - Fax:888-338-9430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty