Organization
LIFELINE HEALTH ESSENTIALS LLC
Active
Other names
The Mastectomy Boutique
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IISHA K BAILEY PHARMD (MANAGER)
(504) 758-4220
Entity
Organization
Contact information
Practice address
4700 WICHERS DR, SUITE 201, MARRERO, LA 70072-3041
(504) 758-4220
Mailing address
PO BOX 2864, HARVEY, LA 70059-2864
(504) 758-4220
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
LA
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
03/06/2017
Last updated
07/21/2022
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