Organization
BOSOM BUDDIES, LLC
Active
Organization
BOSOM BUDDIES, LLC
Active
Other names
Gie Gie Lingerie
Organization subpart
No
Provider details
NPI number
Authorized official
MISS REGINA MASTRANGELO CFM (OWNER)
(610) 296-7626
Entity
Organization
Contact information
Practice address
36 CHESTNUT RD, PAOLI, PA 19301-1565
(610) 296-7626
(610) 296-7620
Mailing address
36 CHESTNUT RD, PAOLI, PA 19301-1565
(610) 296-7626
(610) 296-7620
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
Z6860
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002039000
INDEPENDENCE BLUE CROSS
PA
01
—
1981984
HIGHMARK
PA
Enumeration date
05/10/2007
Last updated
08/01/2013
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