Provider Demographics
NPI:1376648691
Name:TULIPS LINGERIE LLC
Entity type:Organization
Organization Name:TULIPS LINGERIE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:DRATCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-887-6363
Mailing Address - Street 1:419 OLD YORK ROAD
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2704
Mailing Address - Country:US
Mailing Address - Phone:215-887-6363
Mailing Address - Fax:215-887-0493
Practice Address - Street 1:419 YORK RD
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2704
Practice Address - Country:US
Practice Address - Phone:215-887-6363
Practice Address - Fax:215-887-0493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000006673335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA19046OtherAETNA
PA0004903000OtherINDEPENDENCE BLUES
PA0004903000OtherINDEPENDENCE BLUES