E-Dee's Pennyrich Bra Salon

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

E-DEE'S PENNYRICH BRA SALON

Practice address

8043 Allen Rd
Allen Park, MI 48101-1705

Phone

(313) 381-0810

NPI assigned

May 16, 2008

Last updated

May 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Edith Supanich

Title

Owner

Phone

(313) 383-3428

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1700043999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8043 ALLEN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011705",
            "telephone_number": "313-381-0810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8043 ALLEN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011705",
            "telephone_number": "313-381-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E-DEE'S PENNYRICH BRA SALON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "SUPANICH",
        "authorized_official_first_name": "EDITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-383-3428",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Allen Park, MI
• Providers in Allen Park, MI by specialty
• Prosthetic/Orthotic Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.