Provider Demographics
NPI:1740057199
Name:SAM DEL TORO LLC
Entity type:Organization
Organization Name:SAM DEL TORO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN, IBCLC
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:CLAIR
Authorized Official - Last Name:DEL TORO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC
Authorized Official - Phone:205-542-4301
Mailing Address - Street 1:1544 TALHIEM ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832-6512
Mailing Address - Country:US
Mailing Address - Phone:205-542-4301
Mailing Address - Fax:
Practice Address - Street 1:2375 CHAMPIONS BLVD STE 2
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-6471
Practice Address - Country:US
Practice Address - Phone:334-745-6447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty