Organization
CAROLS PERSONAL MASTECTOMY BOUTIQUE
Active
Organization
CAROLS PERSONAL MASTECTOMY BOUTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY R STENQUIST (OWNER)
(801) 483-1262
Entity
Organization
Contact information
Practice address
3165 S MAIN ST, SALT LAKE CITY, UT 84115-3748
(801) 483-1262
(801) 483-1287
Mailing address
3165 S MAIN ST, SALT LAKE CITY, UT 84115-3748
(801) 483-1262
(801) 483-1287
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1744P3200X
UT
Other
Enumeration date
11/19/2007
Last updated
11/28/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up