Provider Demographics
NPI:1609666783
Name:GOLDEN LOTUS LACTATION LLC
Entity type:Organization
Organization Name:GOLDEN LOTUS LACTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:PASQUINI
Authorized Official - Last Name:FELLOWS
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:704-840-8625
Mailing Address - Street 1:5700 KILDARE CT
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-8691
Mailing Address - Country:US
Mailing Address - Phone:704-840-8625
Mailing Address - Fax:
Practice Address - Street 1:5700 KILDARE CT
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-8691
Practice Address - Country:US
Practice Address - Phone:704-840-8625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty