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Organization
ANNS LINGERIE AND MASTECTOMY CENTER, INC
Active
Organization
ANNS LINGERIE AND MASTECTOMY CENTER, INC
Active
Other names
Ann's Bra Shop
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE C BURNS RFM, CMF (PRESIDENT)
(314) 878-4144
Entity
Organization
Contact information
Practice address
13483 OLIVE BLVD, CHESTERFIELD, MO 63017-3166
(314) 878-4144
(314) 878-9146
Mailing address
13483 OLIVE BLVD, CHESTERFIELD, MO 63017
(314) 878-4144
(314) 878-9146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116131
BCBS PROVIDER NUMBER
MO
05
—
6296928808
—
MO
Enumeration date
04/28/2006
Last updated
11/28/2011
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