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Organization

MARCELLA'S BOUTIQUE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DENISE STEWART (MANAGER)
(814) 943-1663
Entity
Organization

Contact information

Practice address
1635 E PLEASANT VALLEY BLVD, ALTOONA, PA 16602-7305
(814) 943-1663
(814) 943-5063
Mailing address
1635 E PLEASANT VALLEY BLVD, ALTOONA, PA 16602-7305
(814) 943-1663
(814) 943-5063

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6000002343
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009261500002
PA
01
200735
HIGHMARK
PA
Enumeration date
02/16/2010
Last updated
02/16/2010
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