Organization
CAROLYNS BOUTIQUE INC
Active
Other names
Elegant Mother
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUNE CAROLYN RODGERS (OWNER PRESIDENT)
(270) 789-0086
Entity
Organization
Contact information
Practice address
903 SOUTH COLUMBIA, CAMPBELLSVILLE, KY 42718
(270) 789-0086
(270) 789-0086
Mailing address
903 SOUTH COLUMBIA, CAMPBELLSVILLE, KY 42718
(270) 789-0086
(270) 789-0086
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90181090
—
KY
Enumeration date
11/29/2006
Last updated
08/22/2020
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