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Organization

LADY OLGA'S LINGERIE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JENIENE M. FERGUSON CMF (OWNER)
(203) 288-1133
Entity
Organization

Contact information

Practice address
3490 WHITNEY AVE, HAMDEN, CT 06518-1936
(203) 288-1133
(203) 288-6399
Mailing address
3490 WHITNEY AVE, HAMDEN, CT 06518-1936
(203) 288-1133
(203) 288-6399

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0605442
AETNA PROVIDER I.D.
CT
01
1081160
HMC/FOCUS PROVIDER I.D.
CT
01
12DME0544CT01
ANTHEM BCBS PROV. I.D.
CT
01
797849
CONNECTICARE PROV. I.D.
CT
01
OR4663
HEALTH NET PROVIDER I.D.
CT
Enumeration date
04/20/2006
Last updated
02/15/2008
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