Organization
ANNS LINGERIE AND MASTECTOMY CENTER, INC
Active
Other names
Ann's Bra Shop
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE C BURNS RFM, CMF (PRESIDENT)
(314) 878-4144
Entity
Organization
Contact information
Practice address
13483 OLIVE BLVD, CHESTERFIELD, MO 63017-3166
(314) 878-4144
(314) 878-9146
Mailing address
13483 OLIVE BLVD, CHESTERFIELD, MO 63017
(314) 878-4144
(314) 878-9146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116131
BCBS PROVIDER NUMBER
MO
05
—
6296928808
—
MO
Enumeration date
04/28/2006
Last updated
11/28/2011
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