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Organization

LUV LINGERIE AND BOUTIQUE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LOU A RABURN (OWNER)
(409) 735-2930
Entity
Organization

Contact information

Practice address
1615 TEXAS AVE, BRIDGE CITY, TX 77611-3530
(409) 735-2930
(409) 735-4513
Mailing address
1615 TEXAS AVE, BRIDGE CITY, TX 77611-3530
(409) 735-2930
(409) 735-4513

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
519608
BLUECROSSBLUESHEILD
TX
Enumeration date
04/02/2007
Last updated
07/21/2008
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