Magnolias Post-Mastectomy Boutique LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MAGNOLIAS POST-MASTECTOMY BOUTIQUE LLC

Practice address

311 W 36TH St
Jasper, IN 47546-9521

Phone

(812) 481-1122

NPI assigned

Mar 24, 2009

Organization subpart

No

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

Authorized official

Name

Cherryl A JedeleNPI 1144279720

Title

Single Member / Owner

Phone

(317) 831-3220

Specialties & licenses 1

Addresses

Tax ID family

Magnolias Post-Mastectomy Boutique LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Magnolias Post-Mastectomy Boutique LLC

  • Durable Medical Equipment & Medical Supplies
  • Mooresville, IN
  • NPI 1720229859
  NPD tax ID

Locations

Practitioners 1

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

• Cherryl Ann Jedele I

  • Specialist
  • Mooresville, IN
  • NPI 1144279720
  NPD (past) Authorized official

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1710129648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S STATE ROAD 67",
            "city": "MOORESVILLE",
            "state": "IN",
            "postal_code": "461582797",
            "telephone_number": "317-831-3220",
            "fax_number": "317-831-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W 36TH ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475469521",
            "telephone_number": "812-481-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIAS POST-MASTECTOMY BOUTIQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "JEDELE",
        "authorized_official_first_name": "CHERRYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SINGLE MEMBER / OWNER",
        "authorized_official_telephone_number": "317-831-3220"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Daniel Long, DDS, MSD
• Michael Seaborn Love, MD
• Bethany Jane Lubenow, P.A.-C
• Jennifer Marie Lueken, M.D.
• Mridu Luray, M.D.
• Tyler William Maharrey, PTA
• Kevin Lee Malone
• Martha F Yearsley M.D. Professional Corporation
• Christine Marie Martin, OTR/L
• Mary L. Zehr

• Durable Medical Equipment & Medical Supplies in Jasper, IN
• Providers in Jasper, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.