Carol'S Personal Mastectomy Boutique of Southern Utah LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CAROL'S PERSONAL MASTECTOMY BOUTIQUE OF SOUTHERN UTAH LLC

Practice address

1490 E Foremaster Dr Ste 310
St George, UT 84790-4504

Phone

(435) 688-0452

Fax

(435) 688-0453

NPI assigned

Sep 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennnifer Flowers, CFM

Title

Owner

Phone

(435) 688-0452

Specialties & licenses 2

Addresses

Other names 1

• Carols Post Mastectomy Spec Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• G Stedman Huard II, M.D.

  • Specialist
  • Saint George, UT
  • NPI 1124084587
  NPD (past)
• Joy Lynne Welsh, M.D.

  • Specialist
  • Saint George, UT
  • NPI 1306802871
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1013014240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 E FOREMASTER DR STE 310",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904504",
            "telephone_number": "435-688-0452",
            "fax_number": "435-688-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 E FOREMASTER DR STE 310",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904504",
            "telephone_number": "435-688-0452",
            "fax_number": "435-688-0453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROL'S PERSONAL MASTECTOMY BOUTIQUE OF SOUTHERN UTAH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "FLOWERS",
        "authorized_official_first_name": "JENNNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-688-0452",
        "authorized_official_credential": "CFM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "UT",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carols Post Mastectomy Spec",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Davis McKay Carlile
• Maranda Star Carlile, FNP-BC
• Angel Carlson
• Joshua Noren Carlson, M.D.
• Casey Carney
• Cody John Carpenter, OTR/L
• Lucy Imma Carpenter
• Tara Carpenter
• Brynlee Gabriella Carr
• Lily Carrier

• Durable Medical Equipment & Medical Supplies in St George, UT
• Providers in St George, UT by specialty
• Durable Medical Equipment & Medical Supplies in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.